NPIMap

Organization Active NPI

Family and Childrens Services of Central Maryland Inc

Doing business as Springboard Community Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Bel Air, MD
National Provider Identifier
1063917334
Registry record updated Aug 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
FAMILY AND CHILDRENS SERVICES OF CENTRAL MARYLAND INC
Doing business as
Springboard Community Services
Practice address
44 E Gordon St
Bel Air, MD 21014-2916
Phone
(410) 838-9000
Fax
(410) 838-8953
NPI assigned
Mar 28, 2018
Last updated
Aug 13, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessie Costley
Title
Credentialing Coordinator
Phone
(410) 366-1980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

44 E Gordon St
Bel Air, MD 21014-2916

Mailing address

4623 Falls Rd
Baltimore, MD 21209-4914
Phone (410) 366-1980

Other identifiers 1

IdentifierTypeStateIssuer
132820402MedicaidMD

Other names 1

  • Springboard Community Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Childrens Services of Central Maryland Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4623 Falls Rd
Baltimore, MD 21209
Phone (410) 366-1980

44 E Gordon St
Bel Air, MD 21014
Phone (410) 803-9617

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1063917334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4623 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094914",
            "telephone_number": "410-366-1980",
            "fax_number": "410-366-8530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 E GORDON ST",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210142916",
            "telephone_number": "410-838-9000",
            "fax_number": "410-838-8953"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY AND CHILDRENS SERVICES OF CENTRAL MARYLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-28",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "COSTLEY",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "410-366-1980"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132820402",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Springboard Community Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.