St. John's Community Services Maryland

Primary specialty

Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X

Legal business name

ST. JOHN'S COMMUNITY SERVICES MARYLAND

Practice address

1406 Merganser CT
Upper Marlboro, MD 20774-7021

Phone

(301) 218-0915

NPI assigned

Jul 12, 2018

Organization subpart

Yes

Parent organization

ST. JOHN'S COMMUNITY SERVICESAs reported in NPPES

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

Authorized official

Name

Mr. Richard C. Bennett

Title

Chief Strategic Initiatives Officer

Phone

(607) 592-2842

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531353600000",
    "number": "1265918288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 WISCONSIN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200074105",
            "telephone_number": "202-237-6391",
            "fax_number": "202-237-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 MERGANSER CT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207747021",
            "telephone_number": "301-218-0915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHN'S COMMUNITY SERVICES MARYLAND",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. JOHN'S COMMUNITY SERVICES",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "CHIEF STRATEGIC INITIATIVES OFFICER",
        "authorized_official_telephone_number": "607-592-2842",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Developmentally Disabled Services Day Training Agency in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Developmentally Disabled Services Day Training Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.