Chance at Life Support Services

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

CHANCE AT LIFE SUPPORT SERVICES

Practice address

110 Dunsford CT
Walkersville, MD 21793-8252

Phone

(443) 226-9790

NPI assigned

Oct 13, 2022

Organization subpart

No

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

Authorized official

Name

Janel Quarles, OWNER

Title

Executive Director

Phone

(443) 226-9790

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1665619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665619200000",
    "number": "1104542927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 HOLDEN RD",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217013426",
            "telephone_number": "443-226-9790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 DUNSFORD CT",
            "city": "WALKERSVILLE",
            "state": "MD",
            "postal_code": "217938252",
            "telephone_number": "443-226-9790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANCE AT LIFE SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-13",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A",
        "authorized_official_last_name": "QUARLES",
        "authorized_official_first_name": "JANEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "443-226-9790",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Brauning, COTA/L
• Johnna Sue Britt, D.D.S.
• Melissa A. Burkhart, OTR
• Danni Deneen Carmichael, M.S.
• Montika Mickiera Carter-Brown
• Samantha Rose Chiorazzo, PA-C
• Stephanie Chorost
• Lindsey Christensen, PTA
• Coaching Salud Holistica, LLC.
• Jessica Cole, FNP-C

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Walkersville, MD
• Providers in Walkersville, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.