Basic Information
| Provider Information | |||||||||
| NPI: | 1104090158 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CONTEMPORARY THERAPEUTIC SERVICES INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 208 | ||||||||
| Address2: | |||||||||
| City: | BURTONSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 208660208 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017798345 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6525 BELCREST RD | ||||||||
| Address2: | SUITE G40 | ||||||||
| City: | HYATTSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207822003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3017798345 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2008 | ||||||||
| LastUpdateDate: | 04/19/2008 | ||||||||
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| AuthorizedOfficialLastName: | HOWDEN | ||||||||
| AuthorizedOfficialFirstName: | STEVE | ||||||||
| AuthorizedOfficialMiddleName: | W | ||||||||
| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 3017798345 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | I | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM0801X | 690504800 | MD | Y | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
ID Information
| ID | Type | State | Issuer | Description | 690504800 | 05 | MD | MEDICAID |