Provider Demographics
NPI:1144625237
Name:INFINITY THERAPEUTIC SERVICES,LLC
Entity type:Organization
Organization Name:INFINITY THERAPEUTIC SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KINGSLEY
Authorized Official - Middle Name:I
Authorized Official - Last Name:DURU
Authorized Official - Suffix:
Authorized Official - Credentials:MSW,LMFT
Authorized Official - Phone:240-640-0406
Mailing Address - Street 1:7606 FONTAINEBLEAU DR APT 211
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3808
Mailing Address - Country:US
Mailing Address - Phone:240-640-0406
Mailing Address - Fax:
Practice Address - Street 1:7606 FONTAINEBLEAU DR
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3808
Practice Address - Country:US
Practice Address - Phone:240-640-0406
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-31
Last Update Date:2014-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333300000XSuppliersEmergency Response System Companies