Provider Demographics
NPI:1750693438
Name:PRICE ODENS ACT II COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:PRICE ODENS ACT II COUNSELING SERVICES, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-498-5766
Mailing Address - Street 1:413 MAIN STREET
Mailing Address - Street 2:#1
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-7101
Mailing Address - Country:US
Mailing Address - Phone:301-498-5766
Mailing Address - Fax:
Practice Address - Street 1:413 MAIN STREET
Practice Address - Street 2:#1
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-7101
Practice Address - Country:US
Practice Address - Phone:301-498-5766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-09
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD903567251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health