Provider Demographics
NPI:1881426336
Name:DMV COMMUNITY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:DMV COMMUNITY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CATHY
Authorized Official - Middle Name:LORAINE
Authorized Official - Last Name:LEMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-622-2762
Mailing Address - Street 1:3455 WILKENS AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21229-5214
Mailing Address - Country:US
Mailing Address - Phone:410-989-3225
Mailing Address - Fax:443-378-8563
Practice Address - Street 1:3455 WILKENS AVE STE 300
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21229-5214
Practice Address - Country:US
Practice Address - Phone:410-989-3225
Practice Address - Fax:443-378-8563
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DMV COMMUNITY HEALTH SERVICES LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder