Open Door Outreach Center

Primary specialty

Case Management AgencyTaxonomy code 251B00000X

Legal business name

OPEN DOOR OUTREACH CENTER

Practice address

13604 Old Annapolis Road
Bowie, MD 20720

Phone

(202) 417-4880

NPI assigned

Jan 2, 2020

Last updated

Jun 8, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wildine Burgess

Title

Executive Director

Phone

(240) 350-2863

Specialties & licenses 4

Addresses

Locations

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

{
    "created_epoch": "1577923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591574400000",
    "number": "1487293940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13604 OLD ANNAPOLIS ROAD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20720",
            "telephone_number": "202-417-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13604 OLD ANNAPOLIS ROAD",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "20720",
            "telephone_number": "202-417-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPEN DOOR OUTREACH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-02",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A",
        "authorized_official_last_name": "BURGESS",
        "authorized_official_first_name": "WILDINE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "240-350-2863"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "174200000X",
            "taxonomy_group": "",
            "desc": "Meals",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Case Management Agency in Bowie, MD
• Providers in Bowie, MD by specialty
• Case Management Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.