Provider Demographics
NPI:1518785831
Name:M&M DEVELOPMENTAL HEALTH LLC
Entity type:Organization
Organization Name:M&M DEVELOPMENTAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MACKENZIE
Authorized Official - Middle Name:ELIZABETH JUNE
Authorized Official - Last Name:MULLINS
Authorized Official - Suffix:
Authorized Official - Credentials:BCABA, LABA
Authorized Official - Phone:567-644-2317
Mailing Address - Street 1:3400 RESIDENTIAL DR
Mailing Address - Street 2:
Mailing Address - City:EDEN
Mailing Address - State:MD
Mailing Address - Zip Code:21822-2234
Mailing Address - Country:US
Mailing Address - Phone:567-644-2317
Mailing Address - Fax:
Practice Address - Street 1:3400 RESIDENTIAL DR
Practice Address - Street 2:
Practice Address - City:EDEN
Practice Address - State:MD
Practice Address - Zip Code:21822-2234
Practice Address - Country:US
Practice Address - Phone:567-644-2317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty