Provider Demographics
NPI:1023993490
Name:NACOSS LLC
Entity type:Organization
Organization Name:NACOSS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:O'DELL
Authorized Official - Middle Name:SYLVESTER
Authorized Official - Last Name:SMOOT
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:240-671-9957
Mailing Address - Street 1:12210 DRUMMOND MAPLE DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-4955
Mailing Address - Country:US
Mailing Address - Phone:240-671-9957
Mailing Address - Fax:
Practice Address - Street 1:5107 LINDEN HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5705
Practice Address - Country:US
Practice Address - Phone:240-671-9957
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-06
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility