| Snlj Outpatient Care Llc | |
|
8400 Corporate Dr Ste 435 Landover MD 20785-2361 | |
| (301) 806-7750 | |
| Not Available |
| Full Name | Snlj Outpatient Care Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 8400 Corporate Dr Ste 435, Landover, Maryland |
| Authorized Official Name and Position | Stacye Brown Loman (PRESIDENT) |
| Authorized Official Contact | 3018067750 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Snlj Outpatient Care Llc 8400 Corporate Dr Ste 435 Landover MD 20785-2361 Ph: (301) 806-7750 | Snlj Outpatient Care Llc 8400 Corporate Dr Ste 435 Landover MD 20785-2361 Ph: (301) 806-7750 |
| NPI Number | 1457162190 |
|---|---|
| Provider Enumeration Date | 01/14/2025 |
| Last Update Date | 01/23/2025 |
| Certification Date | 01/23/2025 |
| Medicare PECOS PAC ID | 2769903459 |
|---|---|
| Medicare Enrollment ID | O20250403000106 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457162190 | NPI | - | NPPES |
| Provider Name | Devon A. Blackwood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1336225077 PECOS PAC ID: 4688195373 Enrollment ID: I20250311001167 |
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