Basic Information
| Provider Information | |||||||||
| NPI: | 1134868839 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ROBERT A. PASCAL YOUTH AND FAMILY SERVICES, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 180 | ||||||||
| Address2: | |||||||||
| City: | ODENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211130180 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105714500 | ||||||||
| FaxNumber: | 4109750204 | ||||||||
| Practice Location | |||||||||
| Address1: | 1230 ANNAPOLIS RD | ||||||||
| Address2: | |||||||||
| City: | ODENTON | ||||||||
| State: | MD | ||||||||
| PostalCode: | 211131320 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105714500 | ||||||||
| FaxNumber: | 4109750204 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2022 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | BONINCONTRI | ||||||||
| AuthorizedOfficialFirstName: | PHILLIP | ||||||||
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| AuthorizedOfficialTitleorPosition: | COO | ||||||||
| AuthorizedOfficialTelephone: | 4109750067 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 05/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 324500000X | Y | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility |
No ID Information.