Organization
EVIDENCE SUPPORT SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FRITZ EBULOH (CEO)
(240) 716-4638
Entity
Organization
Contact information
Practice address
2402 LAKE FOREST DR, UPPER MARLBORO, MD 20774-8983
(240) 716-4638
Mailing address
2410 SUSAN HODGES PL, UPPER MARLBORO, MD 20774-8945
(240) 716-4638
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
251S00000X
Community/Behavioral Health Agency
—
—
Other
Enumeration date
04/07/2025
Last updated
04/07/2025
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