Snlj Outpatient Care Llc | |
8400 Corporate Dr Ste 435 Landover MD 20785-2361 | |
(301) 806-7750 | |
Not Available |
Full Name | Snlj Outpatient Care Llc |
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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 |
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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 |
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Provider Enumeration Date | 01/14/2025 |
Last Update Date | 01/23/2025 |
Certification Date | 01/23/2025 |
Medicare PECOS PAC ID | 2769903459 |
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Medicare Enrollment ID | O20250311001207 |
Identifier | Type | State | Issuer |
---|---|---|---|
1457162190 | NPI | - | NPPES |
Provider Name | Devon A. Blackwood |
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Provider Type | Practitioner - Mental Health Counselor |
Provider Identifiers | NPI Number: 1336225077 PECOS PAC ID: 4688195373 Enrollment ID: I20250311001167 |
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