Organization · NPI-2

1st Medical Pain Management Specialists

Clinic/Center, Multi-Specialty · Silver Spring, MD

NPI number1629743034
StatusActive
Last updated in NPPESJan 23, 2022

Details

NPI
1629743034
Entity type
Organization (NPI-2)
Legal business name
1st Medical Pain Management Specialists
Organization subpart
Yes
Enumeration date
Aug 9, 2021
Certification date
Jan 23, 2022
Last updated
Jan 23, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261QM1300X Clinic/Center, Multi-Specialty––Yes
1041C0700X Social Worker, Clinical––
225C00000X Rehabilitation Counselor––
251S00000X Community/Behavioral Health––
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)––
261QM0850X Clinic/Center, Adult Mental Health––
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)––
101YA0400X Counselor, Addiction (Substance Use Disorder)––
101YM0800X Counselor, Mental Health––
103TA0400X Psychologist, Addiction (Substance Use Disorder)––
261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder––

Other names

  • 1st Medical Painrehab Center (Doing Business As)

Practice location

831 University Blvd E Ste 34
Silver Spring, MD 20903-2915

Phone 301-408-2720 · Fax 301-408-2725

Mailing address

831 University Blvd E Ste 34
Silver Spring, MD 20903-2915

Phone 301-408-2720 · Fax 301-408-4503

Authorized official

Rosemary Ingado
Clinical Administrator
4109566800

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