King Community Services LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

KING COMMUNITY SERVICES LLC

Practice address

5034 Dorsey Hall Dr Ste 202
Ellicott City, MD 21042-7502

Phone

(410) 615-9499

NPI assigned

Jan 3, 2023

Organization subpart

No

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

Authorized official

Name

Charles Dunmore

Title

Owner

Phone

(410) 615-9499

Specialties & licenses 1

Addresses

Electronic endpoints 1

Tax ID family

King Community Services LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• King Community Services LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Ellicott City, MD
  • NPI 1821770553
  NPD tax ID

Locations

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1487367660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5034 DORSEY HALL DR STE 202",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5034 DORSEY HALL DR STE 202",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427502",
            "telephone_number": "410-615-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KING COMMUNITY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "DUNMORE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-615-9499"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.kingcommunitysvcs.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5034 Dorsey Hall Dr Ste 202",
            "city": "Ellicott City",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210427502",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Victor Yonghoon Kim, M.D.
• Young Joo Kim
• Kimberly Marie Ford, DDS, LLC
• Jennifer Kincaid, PH.D., CCC-A, FAAA
• Kristina Lee Kincaid, LCSW-C
• King Community Services LLC
• Samantha Michelle King-Diener, M.S., CCC-SLP
• Olivia Peyton Kirkendall
• KJT Support Solutions
• Kitt Lena Klassen, LGPC

• Community/Behavioral Health Agency in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.