Provider Demographics
NPI:1952881609
Name:SIBUS TREATMENT SERVICES LLC
Entity Type:Organization
Organization Name:SIBUS TREATMENT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GALAHER
Authorized Official - Suffix:
Authorized Official - Credentials:NA
Authorized Official - Phone:410-991-5687
Mailing Address - Street 1:6170 HUNT CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5518
Mailing Address - Country:US
Mailing Address - Phone:410-991-5687
Mailing Address - Fax:
Practice Address - Street 1:6170 HUNT CLUB RD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075
Practice Address - Country:US
Practice Address - Phone:410-991-5687
Practice Address - Fax:443-820-3376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-21
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone