Provider Demographics
NPI:1619364825
Name:SIA HEALTH SOLUTIONS, INC.
Entity type:Organization
Organization Name:SIA HEALTH SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:BOBBI
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-410-8642
Mailing Address - Street 1:7620 CARROLL AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6387
Mailing Address - Country:US
Mailing Address - Phone:301-270-1524
Mailing Address - Fax:301-270-1523
Practice Address - Street 1:7620 CARROLL AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6387
Practice Address - Country:US
Practice Address - Phone:301-270-1524
Practice Address - Fax:301-270-1523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-25
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD58483261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health