Organization
CENTER FOR COMPREHENSIVE SERVICES
Active
Other names
NeuroRestorative Maryland
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LOREYONNA S JOHNSON-WILLIAMS (AR ANALYST)
(813) 626-1444
Entity
Organization
Contact information
Practice address
12312 MILLSTREAM DR, BOWIE, MD 20715-1547
(301) 352-2979
(301) 262-6089
Mailing address
10150 HIGHLAND MANOR DR, SUITE 140, TAMPA, FL 33610-9713
(813) 626-1444
(813) 621-0770
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
631801100
—
MD
Enumeration date
07/18/2011
Last updated
07/18/2011
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