Provider Demographics
NPI:1770964918
Name:C & J GLOBAL COMPREHENSIVE THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:C & J GLOBAL COMPREHENSIVE THERAPEUTIC SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JUDITH
Authorized Official - Middle Name:EBAI
Authorized Official - Last Name:ABUNAW
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:240-355-1753
Mailing Address - Street 1:1603 SCOTCH PINE DR
Mailing Address - Street 2:
Mailing Address - City:MITCHELLVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2789
Mailing Address - Country:US
Mailing Address - Phone:301-758-0263
Mailing Address - Fax:301-925-9395
Practice Address - Street 1:1603 SCOTCH PINE DR
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-2789
Practice Address - Country:US
Practice Address - Phone:301-758-0263
Practice Address - Fax:301-925-9395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-13
Last Update Date:2015-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC50079320251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health