Provider Demographics
NPI:1740997378
Name:TEEN CHECK ASSISTANTS, LC
Entity type:Organization
Organization Name:TEEN CHECK ASSISTANTS, LC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:NICHOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-856-1152
Mailing Address - Street 1:8948 TOWN AND COUNTRY BLVD APT C
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3118
Mailing Address - Country:US
Mailing Address - Phone:240-998-8500
Mailing Address - Fax:
Practice Address - Street 1:8948 TOWN AND COUNTRY BLVD APT C
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21043-3118
Practice Address - Country:US
Practice Address - Phone:240-998-8500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-02
Last Update Date:2022-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty