Organization
INTERDYNAMICS, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOAN BRANCH (CEO)
(301) 306-4590
Entity
Organization
Contact information
Practice address
4601 FORBES BOULEVARD, SUITE100, LANHAM, MD 20706-4807
(301) 306-4590
(301) 880-0054
Mailing address
4601 FORBES BLVD, SUITE100, LANHAM, MD 20706-4807
(301) 306-4590
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
01660
MD
251S00000X
Community/Behavioral Health Agency
Primary
01160
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
535443
PTAN
MD
Enumeration date
12/19/2016
Last updated
12/19/2016
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