Provider Demographics
NPI:1457776270
Name:AGS PROGRAMS LLC
Entity Type:Organization
Organization Name:AGS PROGRAMS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RASCHID
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-804-0766
Mailing Address - Street 1:1807 E PRESTON ST
Mailing Address - Street 2:WOLFE STREET SUITE
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21213-3131
Mailing Address - Country:US
Mailing Address - Phone:410-276-2123
Mailing Address - Fax:410-276-4070
Practice Address - Street 1:1807 E PRESTON ST
Practice Address - Street 2:WOLFE STREET SUITE
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21213-3131
Practice Address - Country:US
Practice Address - Phone:410-276-2123
Practice Address - Fax:410-276-4070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-03
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD423281000Medicaid