| Diversified Treatment Services Llc | |
|
10104 Senate Dr Suite 228 Lanham MD 20706-4392 | |
| (301) 577-4920 | |
| (301) 577-4940 |
| Full Name | Diversified Treatment Services Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 10104 Senate Dr, Lanham, Maryland |
| Authorized Official Name and Position | Alphonso Lewis (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3015774920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Diversified Treatment Services Llc 10104 Senate Dr Suite 228 Lanham MD 20706-4392 Ph: (301) 577-4920 | Diversified Treatment Services Llc 10104 Senate Dr Suite 228 Lanham MD 20706-4392 Ph: (301) 577-4920 |
| NPI Number | 1003216656 |
|---|---|
| Provider Enumeration Date | 09/02/2014 |
| Last Update Date | 09/02/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003216656 | NPI | - | NPPES |
| 664315 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | LC3460 (Maryland) | Primary |
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