| Evidence Support Services | |
|
2402 Lake Forest Dr Upper Marlboro MD 20774-8983 | |
| (240) 716-4638 | |
| Not Available |
| Full Name | Evidence Support Services |
|---|---|
| Speciality | Day Training, Developmentally Disabled Services |
| Location | 2402 Lake Forest Dr, Upper Marlboro, Maryland |
| Authorized Official Name and Position | Fritz Ebuloh (CEO) |
| Authorized Official Contact | 2407164638 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Evidence Support Services 2410 Susan Hodges Pl Upper Marlboro MD 20774-8945 Ph: (240) 716-4638 | Evidence Support Services 2402 Lake Forest Dr Upper Marlboro MD 20774-8983 Ph: (240) 716-4638 |
| NPI Number | 1538953328 |
|---|---|
| Provider Enumeration Date | 04/07/2025 |
| Last Update Date | 04/07/2025 |
| Certification Date | 04/07/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538953328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 251C00000X | Day Training, Developmentally Disabled Services | (* (Not Available)) | Primary |
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