NPIMap

Organization Active NPI

Axis Support Services

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Middle River, MD
National Provider Identifier
1366074312
Registry record updated Feb 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
AXIS SUPPORT SERVICES
Doing business as
Axis Support Services
Practice address
9721 Luguna Rd
Middle River, MD 21220-3769
Phone
(443) 226-3289
NPI assigned
Feb 7, 2020
Last updated
Feb 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2020

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • Axis Support Services Doing business as

Electronic endpoints 1

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

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1581033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581033600000",
    "number": "1366074312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9721 LUGUNA RD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203769",
            "telephone_number": "443-226-3289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9721 LUGUNA RD",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212203769",
            "telephone_number": "443-226-3289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AXIS SUPPORT SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-07",
        "last_updated": "2020-02-07",
        "certification_date": "2020-02-07",
        "status": "A",
        "authorized_official_last_name": "LONGE",
        "authorized_official_first_name": "OLABODE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "109-298-4494",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CISA, CA"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "olalonge2000@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Through end point to end point secured mail (i.e. virtru",
            "address_1": "9721 Luguna Rd",
            "city": "Middle River",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212203769",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Axis Support Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middle River, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 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.