Basic Information
Provider Information
NPI: 1548708761
EntityType: 2
ReplacementNPI:  
OrganizationName: CONTEMPORARY FAMILY SERVICES, INC
LastName:  
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MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
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Mailing Information
Address1: 3455 WILKINS AVE
Address2: SUITE 308/208
City: BALTIMORE CITY
State: MD
PostalCode: 212295213
CountryCode: US
TelephoneNumber: 4105258601
FaxNumber: 4105258602
Practice Location
Address1: 3455 WILKENS AVE
Address2: SUITE 308/208
City: BALTIMORE
State: MD
PostalCode: 212295213
CountryCode: US
TelephoneNumber: 4105258601
FaxNumber: 4105258602
Other Information
ProviderEnumerationDate: 02/08/2017
LastUpdateDate: 02/08/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: MONROE
AuthorizedOfficialFirstName: JOHN
AuthorizedOfficialMiddleName: LEWIS
AuthorizedOfficialTitleorPosition: CEO
AuthorizedOfficialTelephone: 2403751957
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix: DR.
AuthorizedOfficialNameSuffix: JR.
AuthorizedOfficialCredential: DSW
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251S00000XMH-2113MDY AgenciesCommunity/Behavioral Health 

No ID Information.


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