|
| |
|
164 Freedom Ln Lonaconing MD 21539-2004 | |
| (301) 463-3378 | |
| (301) 463-3376 |
| Full Name | |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 164 Freedom Ln, Lonaconing, Maryland |
| Authorized Official Name and Position | Tammy Lynn Fisher (ADMINISTRATOR-CLINICAL SUPERVISOR) |
| Authorized Official Contact | 3014633376 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
164 Freedom Ln Lonaconing MD 21539-2004 Ph: (301) 463-3378 | 164 Freedom Ln Lonaconing MD 21539-2004 Ph: (301) 463-3378 |
| NPI Number | 1437370509 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437370509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
Lukas Behavioral Health Llc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 17 Main St, Lonaconing, MD 21539 Phone: 301-876-4889 Fax: 240-362-7118 |