NPIMap

Organization Active NPI

CMDS Residential, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Baltimore, MD
National Provider Identifier
1679102719
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
Legal business name
CMDS RESIDENTIAL, LLC
Practice address
6040 Harford Rd
Baltimore, MD 21214-1327
Phone
(443) 864-4027
NPI assigned
Apr 1, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Authorized official

Name
Andre L Pelegrini
Title
VP Finance
Phone
(410) 868-5638

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X Primary

Addresses

Primary practice location

6040 Harford Rd
Baltimore, MD 21214-1327

Mailing address

5570 Sterrett PL Ste 300
Columbia, MD 21044-2678
Phone (410) 868-5638

National Provider Directory

National Provider Directory
Tax ID family
CMDS Residential LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1585699200000",
    "number": "1679102719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5570 STERRETT PL STE 300",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442678",
            "telephone_number": "410-868-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 HARFORD RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141327",
            "telephone_number": "443-864-4027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMDS RESIDENTIAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A",
        "authorized_official_last_name": "PELEGRINI",
        "authorized_official_first_name": "ANDRE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP FINANCE",
        "authorized_official_telephone_number": "410-868-5638"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.