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Organization

ACT IV

Active
Other names
Community Service Agency
Organization subpart
No

Provider details

NPI number
Authorized official
MR. CARROLL PARKS (DIRECTOR OF ADULT SERVICES)
(202) 698-2525
Entity
Organization

Contact information

Practice address
10005 LAWRENCE POND CT, LAUREL, MD 20708-3049
(301) 362-1771
Mailing address
10005 LAWRENCE POND CT, LAUREL, MD 20708-3049
(301) 362-1771

Taxonomy

Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
H423356201579
MD

Other

Enumeration date
03/19/2007
Last updated
06/16/2008
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