Forma Care Services

Primary specialty

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

Legal business name

FORMA CARE SERVICES

Practice address

39 E Franklin St Ste C
Hagerstown, MD 21740-4914

Phone

(240) 543-5972

NPI assigned

Apr 17, 2024

Organization subpart

No

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

Authorized official

Name

Oluwaseun Ogunleye

Title

Founder

Phone

(240) 543-5972

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1713312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716854400000",
    "number": "1396599098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9611 MASON LN",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207231907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 E FRANKLIN ST STE C",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217404914",
            "telephone_number": "240-543-5972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORMA CARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-17",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A",
        "authorized_official_last_name": "OGUNLEYE",
        "authorized_official_first_name": "OLUWASEUN",
        "authorized_official_title_or_position": "FOUNDER",
        "authorized_official_telephone_number": "240-543-5972"
    },
    "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": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Hagerstown, MD
• Providers in Hagerstown, 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 May 28, 2024; 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.