| Bac Health Services Llc | |
|
14300 Cherry Lane Ct Ste 108 Laurel MD 20707-4978 | |
| (240) 713-8080 | |
| (240) 993-5700 |
| Full Name | Bac Health Services Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 14300 Cherry Lane Ct Ste 108, Laurel, Maryland |
| Authorized Official Name and Position | Josephine Tafie (PROVIDER) |
| Authorized Official Contact | 2405659022 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bac Health Services Llc 14300 Cherry Lane Ct Ste 108 Laurel MD 20707-4978 Ph: (240) 713-8080 | Bac Health Services Llc 14300 Cherry Lane Ct Ste 108 Laurel MD 20707-4978 Ph: (240) 713-8080 |
| NPI Number | 1356033609 |
|---|---|
| Provider Enumeration Date | 05/24/2023 |
| Last Update Date | 11/06/2024 |
| Certification Date | 11/06/2024 |
| Medicare PECOS PAC ID | 5698129419 |
|---|---|
| Medicare Enrollment ID | O20230928000227 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356033609 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Josephine Tafie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871937482 PECOS PAC ID: 4587089420 Enrollment ID: I20210407002643 |
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