Provider Demographics
NPI:1548270663
Name:ALL THATS THERAPEUTIC INC
Entity type:Organization
Organization Name:ALL THATS THERAPEUTIC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:BOFFMAN
Authorized Official - Last Name:CHISM
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-567-0400
Mailing Address - Street 1:6188 OXON HILL RD
Mailing Address - Street 2:SUITE 500
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-3113
Mailing Address - Country:US
Mailing Address - Phone:301-567-0400
Mailing Address - Fax:301-567-7900
Practice Address - Street 1:6188 OXON HILL RD
Practice Address - Street 2:SUITE 500
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-3113
Practice Address - Country:US
Practice Address - Phone:301-567-0400
Practice Address - Fax:301-567-7900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD404125900Medicaid
MD402108800Medicaid