| Legacy Family Services, Llc | |
|
11415 Old Pond Dr Glenn Dale MD 20769-9154 | |
| (301) 200-2919 | |
| Not Available |
| Full Name | Legacy Family Services, Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 11415 Old Pond Dr, Glenn Dale, Maryland |
| Authorized Official Name and Position | Angela T Dudley Hamilton (OWNER) |
| Authorized Official Contact | 2027464345 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Legacy Family Services, Llc 11415 Old Pond Dr Glenn Dale MD 20769-9154 Ph: () - | Legacy Family Services, Llc 11415 Old Pond Dr Glenn Dale MD 20769-9154 Ph: (301) 200-2919 |
| NPI Number | 1770180838 |
|---|---|
| Provider Enumeration Date | 10/01/2020 |
| Last Update Date | 10/01/2020 |
| Certification Date | 10/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770180838 | NPI | - | NPPES |
| EM58-0000 | Other | CAREFIRST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Primary |
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