Provider Demographics
NPI:1023282662
Name:FLO DIAMOND INC
Entity type:Organization
Organization Name:FLO DIAMOND INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:N
Authorized Official - Last Name:BIKUNDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-486-6145
Mailing Address - Street 1:600 REISTERSTOWN RD
Mailing Address - Street 2:SUITE 300A
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208
Mailing Address - Country:US
Mailing Address - Phone:410-486-6145
Mailing Address - Fax:410-486-6147
Practice Address - Street 1:817 SILVER SPRING AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910
Practice Address - Country:US
Practice Address - Phone:301-565-7865
Practice Address - Fax:301-565-0595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR167174253J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253J00000XAgenciesFoster Care Agency