Organization
DIVERSIFIED TREATMENT SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALPHONSO LEWIS (EXECUTIVE DIRECTOR)
(301) 577-4920
Entity
Organization
Contact information
Practice address
10104 SENATE DR, SUITE 228, LANHAM, MD 20706-4392
(301) 577-4920
(301) 577-4940
Mailing address
10104 SENATE DR, SUITE 228, LANHAM, MD 20706-4392
(301) 577-4920
(301) 577-4940
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC3460
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
664315
—
MD
Enumeration date
09/02/2014
Last updated
09/02/2014
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