Link Introserve Inc

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

Legal business name

LINK INTROSERVE INC

Practice address

5100 Buckeystown Pike Ste 250
Frederick, MD 21704-8344

Phone

(929) 331-7694

NPI assigned

Apr 15, 2024

Last updated

Apr 15, 2024By 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

Azeez Agbaje

Title

Manager

Phone

(929) 331-7694

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1713139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713139200000",
    "number": "1720832090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "929-331-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5100 BUCKEYSTOWN PIKE STE 250",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217048344",
            "telephone_number": "929-331-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINK INTROSERVE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-15",
        "last_updated": "2024-04-15",
        "certification_date": "2024-04-14",
        "status": "A",
        "authorized_official_last_name": "AGBAJE",
        "authorized_official_first_name": "AZEEZ",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "929-331-7694"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Frederick, MD
• Providers in Frederick, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.