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Abreast Therapeutic Center, Inc

Organization Active NPI Multi-Specialty Clinic/Center · Lanham, MD

NPI 1053036640 · NPPES record last updated Jan 27, 2023

Key facts

NPI
1053036640
Entity type
Organization (NPI type 2)
Primary specialty
Multi-Specialty Clinic/Center 261QM1300X
Legal business name
ABREAST THERAPEUTIC CENTER, INC
Practice address
9418 Annapolis Rd Ste 202
Lanham, MD 20706-3053
Phone
(240) 764-5180
NPI assigned
Oct 6, 2022
Organization subpart
No

Authorized official

Name
Mr. Abayomi Sokoya
Title
President
Phone
(240) 764-5180

Corporate family (same tax ID) 7

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Abreast Therapeutic Center Inc (8 organizations share this tax ID)

Locations

9418 Annapolis Rd
Ste 200
Lanham, MD 20706

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X
Multi-Specialty Clinic/Center 261QM1300X Yes
Medical Specialty Clinic/Center 261QM2500X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X
Substance Abuse Rehabilitation Facility 324500000X

Addresses

Primary practice location

9418 Annapolis Rd Ste 202
Lanham, MD 20706-3053

Mailing address

9418 Annapolis Rd Ste 200
Lanham, MD 20706-3052
Phone (240) 764-5180

Other identifiers

IdentifierTypeStateIssuer
888175800MedicaidMD

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jan 27, 2023.

{
    "created_epoch": "1665014400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674777600000",
    "number": "1053036640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9418 ANNAPOLIS RD STE 200",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063052",
            "telephone_number": "240-764-5180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9418 ANNAPOLIS RD STE 202",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063053",
            "telephone_number": "240-764-5180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABREAST THERAPEUTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-06",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-26",
        "status": "A",
        "authorized_official_last_name": "SOKOYA",
        "authorized_official_first_name": "ABAYOMI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-764-5180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "888175800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lanham, MD

All providers in Lanham, MD · Multi-Specialty Clinic/Center in Maryland

Sources for this page

Verify at the official NPI Registry.