Organization
VINTAGE HEALTHCARE SERVICES L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH JONES (CEO)
(202) 843-3535
Entity
Organization
Contact information
Practice address
10310 SWIFT STREAM PL APT 109, COLUMBIA, MD 21044-4881
(202) 843-3537
Mailing address
1201 CONNECTICUT AVE NW STE 531, WASHINGTON, DC 20036-2729
(202) 843-3537
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261Q00000X
Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
03/17/2025
Last updated
03/18/2025
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