| Affiliated Sante Group | |
|
4355 Nicole Dr Lanham MD 20706-4349 | |
| (301) 429-2171 | |
| Not Available |
| Full Name | Affiliated Sante Group |
|---|---|
| Speciality | Psychologist |
| Location | 4355 Nicole Dr, Lanham, Maryland |
| Authorized Official Name and Position | Fred Chanteau (CEO) |
| Authorized Official Contact | 3015726585 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Affiliated Sante Group 12200 Tech Rd Suite 330 Silver Spring MD 20904-1983 Ph: (301) 787-5692 | Affiliated Sante Group 4355 Nicole Dr Lanham MD 20706-4349 Ph: (301) 429-2171 |
| NPI Number | 1013348267 |
|---|---|
| Provider Enumeration Date | 12/12/2013 |
| Last Update Date | 02/10/2020 |
| Certification Date | 02/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013348267 | NPI | - | NPPES |
| 422027700 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
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