NPIMap

Organization Active NPI

CMDS Residential, LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Baltimore, MD
National Provider Identifier
1104479401
Registry record updated Jan 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
CMDS RESIDENTIAL, LLC
Practice address
6040 Harford Rd
Baltimore, MD 21214-1327
Phone
(443) 864-4027
NPI assigned
Jul 17, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2020

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

Authorized official

Name
Andre Pelegrini
Title
Dir Finance
Phone
(443) 864-4027

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

6040 Harford Rd
Baltimore, MD 21214-1327

Mailing address

5570 Sterrett PL Ste 300
Columbia, MD 21044-2678
Phone (443) 864-4027

National Provider Directory

National Provider Directory
Tax ID family
CMDS Residential LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578009600000",
    "number": "1104479401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5570 STERRETT PL STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442678",
            "telephone_number": "443-864-4027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141327",
            "telephone_number": "443-864-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMDS RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2020-01-03",
        "certification_date": "2020-01-03",
        "status": "A",
        "authorized_official_last_name": "PELEGRINI",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_title_or_position": "DIR FINANCE",
        "authorized_official_telephone_number": "443-864-4027"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.