Provider Demographics
NPI:1861917395
Name:CHILD QUEST LLC
Entity type:Organization
Organization Name:CHILD QUEST LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/EDUCATIONAL SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:TINA
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-401-4607
Mailing Address - Street 1:1416 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4214
Mailing Address - Country:US
Mailing Address - Phone:240-285-0080
Mailing Address - Fax:240-668-6767
Practice Address - Street 1:5716 INDUSTRY LN STE G
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21704-5201
Practice Address - Country:US
Practice Address - Phone:301-401-4607
Practice Address - Fax:240-668-6767
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-05
Last Update Date:2017-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251S00000XAgenciesCommunity/Behavioral Health