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Axis Support Services

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Middle River, MD

NPI 1366074312 · NPPES record last updated Feb 7, 2020

Key facts

NPI
1366074312
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
AXIS SUPPORT SERVICES
Practice address
9721 Luguna Rd
Middle River, MD 21220-3769
Phone
(443) 226-3289
NPI assigned
Feb 7, 2020
Organization subpart
No

Authorized official

Name
Mr. Olabode G Longe, CISA, CA
Title
Chief Executive Officer
Phone
(109) 298-4494

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

9721 Luguna Rd
Middle River, MD 21220-3769

Mailing address

9721 Luguna Rd
Middle River, MD 21220-3769
Phone (443) 226-3289

Other names

  • Axis Support Services Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL olalonge2000@gmail.com Health Information Exchange (HIE)

Other providers in Middle River, MD

All providers in Middle River, MD · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

Sources for this page

Verify at the official NPI Registry.