Basic Information
| Provider Information | |||||||||
| NPI: | 1811521347 | ||||||||
| EntityType: | 2 | ||||||||
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| 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 | ||||||||
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| Practice Location | |||||||||
| Address1: | 43 COMMUNITY PL | ||||||||
| Address2: | |||||||||
| City: | CROWNSVILLE | ||||||||
| State: | MD | ||||||||
| PostalCode: | 210322034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4105714500 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2020 | ||||||||
| LastUpdateDate: | 10/28/2021 | ||||||||
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| AuthorizedOfficialLastName: | LAMB | ||||||||
| AuthorizedOfficialFirstName: | KIMBERLY | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF ADMINISTRATION | ||||||||
| AuthorizedOfficialTelephone: | 4109750067 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 163WA0400X | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Addiction (Substance Use Disorder) | 163WP0809X | N | 193200000X MULTI-SPECIALTY GROUP | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult | 261QR0405X | Y | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
No ID Information.