NPIMap

Organization Active NPI

Vine Residential Services

  • Developmental Disabilities Clinic/Center
  • Essex, MD
National Provider Identifier
1427869866
Registry record updated Jan 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
VINE RESIDENTIAL SERVICES
Practice address
707 Norris LN
Essex, MD 21221-2140
Phone
(443) 473-9773
Fax
(443) 961-8169
NPI assigned
Jan 15, 2025
Last updated
Jan 15, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2025

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

Authorized official

Name
Marcus MottonNPI 1013435387
Title
Program Director
Phone
(443) 473-9773

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X NU Primary

Addresses

Primary practice location

707 Norris LN
Essex, MD 21221-2140

Mailing address

703 N Carey St
Baltimore, MD 21217-2412
Phone (443) 473-9773

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1736899200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736899200000",
    "number": "1427869866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "703 N CAREY ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212172412",
            "telephone_number": "443-473-9773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 NORRIS LN",
            "city": "ESSEX",
            "state": "MD",
            "postal_code": "212212140",
            "telephone_number": "443-473-9773",
            "fax_number": "443-961-8169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VINE RESIDENTIAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-15",
        "last_updated": "2025-01-15",
        "certification_date": "2025-01-15",
        "status": "A",
        "authorized_official_last_name": "MOTTON",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_title_or_position": "PROGRAM DIRECTOR",
        "authorized_official_telephone_number": "443-473-9773"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Essex, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2025; 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.