Active NPI
Second Mile Services, LLC
- Developmentally Disabled Services Day Training Agency
- Rosedale, MD
National Provider Identifier
1467275347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmentally Disabled Services Day Training Agency
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 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 DirectoryLocations
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.