| Family Service Foundation, Inc | |
|
306 Delaware Road Frederick MD 21701-4618 | |
| (301) 378-0261 | |
| (301) 378-0267 |
| Full Name | Family Service Foundation, Inc |
|---|---|
| Speciality | Psychologist - Rehabilitation |
| Location | 306 Delaware Road, Frederick, Maryland |
| Authorized Official Name and Position | Daphne Smith (BILLING MANAGER) |
| Authorized Official Contact | 3014592121 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Service Foundation, Inc 5301 76th Ave Landover Hills MD 20784-1703 Ph: (301) 459-2121 | Family Service Foundation, Inc 306 Delaware Road Frederick MD 21701-4618 Ph: (301) 378-0261 |
| NPI Number | 1093039182 |
|---|---|
| Provider Enumeration Date | 03/18/2010 |
| Last Update Date | 09/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093039182 | NPI | - | NPPES |
| 320741200 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TR0400X | Psychologist - Rehabilitation | 4163 (Maryland) | Primary |
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