Organization Active NPI

Second Mile Services, LLC

  • Developmentally Disabled Services Day Training Agency
  • Rosedale, MD
National Provider Identifier
1467275347
Registry record updated Nov 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmentally Disabled Services Day Training AgencyTaxonomy code 251C00000X
Legal business name
SECOND MILE SERVICES, LLC
Practice address
6801 Golden Ring Rd
Rosedale, MD 21237-2104
Phone
(443) 224-5057
NPI assigned
Nov 7, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2024

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

Authorized official

Name
Mr. Casteel Johnson
Title
Ceo
Phone
(443) 224-5057

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Case Management Agency 251B00000X
Developmentally Disabled Services Day Training Agency 251C00000X Primary
Community/Behavioral Health Agency 251S00000X
Supports Brokerage Agency 251X00000X
Early Intervention Provider Agency 252Y00000X
In Home Supportive Care Agency 253Z00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Respite Care 385H00000X

Addresses

Primary practice location

6801 Golden Ring Rd
Rosedale, MD 21237-2104

Mailing address

104 E 25TH St
Baltimore, MD 21218-5252
Phone (443) 224-5057

National Provider Directory

National Provider Directory

Locations

104 E 25th St
Baltimore, MD 21218

NPI Registry JSON

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

{
    "created_epoch": "1730937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730937600000",
    "number": "1467275347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E 25TH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212185252",
            "telephone_number": "443-224-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6801 GOLDEN RING RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372104",
            "telephone_number": "443-224-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECOND MILE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-07",
        "last_updated": "2024-11-07",
        "certification_date": "2024-11-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CASTEEL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-224-5057",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251X00000X",
            "taxonomy_group": "",
            "desc": "Supports Brokerage",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

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