Provider Demographics
NPI:1043910920
Name:CONCEPT FOR WOMEN AND CHILDREN WITH HIV AIDS INC
Entity type:Organization
Organization Name:CONCEPT FOR WOMEN AND CHILDREN WITH HIV AIDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LOVELYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BIALOSE
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP-FNP, PMH-BC
Authorized Official - Phone:301-552-4444
Mailing Address - Street 1:9801 GREENBELT RD STE 318
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-6231
Mailing Address - Country:US
Mailing Address - Phone:301-552-4444
Mailing Address - Fax:
Practice Address - Street 1:9801 GREENBELT RD STE 318
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6231
Practice Address - Country:US
Practice Address - Phone:301-552-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-08
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty