Bootsie Center, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

BOOTSIE CENTER, LLC

Doing business as

Bootsie Center

Practice address

1925 Scientists Cliffs Rd
Port Republic, MD 20676-2405

Phone

(410) 474-6546

NPI assigned

Nov 11, 2024

Last updated

Nov 11, 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

Rakeeda Commodore-Jenkins

Title

LCSW-C

Phone

(410) 474-6546

Specialties & licenses 1

Addresses

Other names 1

• Bootsie Center Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Rakeeda Commodore

  • Clinical Social Worker
  • Port Republic, MD
  • NPI 1366830465
  NPD

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

{
    "created_epoch": "1731283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731283200000",
    "number": "1730903220",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 SCIENTISTS CLIFFS RD",
            "city": "PORT REPUBLIC",
            "state": "MD",
            "postal_code": "206762405",
            "telephone_number": "410-474-6546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 SCIENTISTS CLIFFS RD",
            "city": "PORT REPUBLIC",
            "state": "MD",
            "postal_code": "206762405",
            "telephone_number": "410-474-6546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOOTSIE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-11",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A",
        "authorized_official_last_name": "COMMODORE-JENKINS",
        "authorized_official_first_name": "RAKEEDA",
        "authorized_official_title_or_position": "LCSW-C",
        "authorized_official_telephone_number": "410-474-6546"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bootsie Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Danielle Rae Behrens, LCPC
• Rakeeda Commodore
• Maple Consulting, LLC
• Meek Care LLC
• Joyceline Muma
• Lavaughn Murray

• Community/Behavioral Health Agency in Port Republic, MD
• Providers in Port Republic, 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 Nov 11, 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.