Provider Demographics
NPI:1043950298
Name:SUPPORT SERVICES OF MARYLAND INC
Entity type:Organization
Organization Name:SUPPORT SERVICES OF MARYLAND INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:INNOCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPUAKA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE BSN
Authorized Official - Phone:410-424-9495
Mailing Address - Street 1:6817 REAL PRINCESS LN
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4493
Mailing Address - Country:US
Mailing Address - Phone:410-424-9495
Mailing Address - Fax:
Practice Address - Street 1:839 SECURITY RD
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4144
Practice Address - Country:US
Practice Address - Phone:410-424-9495
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-29
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251E00000XAgenciesHome Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health