Provider Demographics
NPI:1871779819
Name:SOCIAL HEALTH SERVICES GROUP INC
Entity type:Organization
Organization Name:SOCIAL HEALTH SERVICES GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEDRICK
Authorized Official - Middle Name:EDWIN
Authorized Official - Last Name:SAWYERR
Authorized Official - Suffix:
Authorized Official - Credentials:MURP-MS URBREG PLNG
Authorized Official - Phone:301-358-4447
Mailing Address - Street 1:7304 LOANDA DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-4273
Mailing Address - Country:US
Mailing Address - Phone:301-358-4447
Mailing Address - Fax:240-547-0620
Practice Address - Street 1:7304 LOANDA DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-4273
Practice Address - Country:US
Practice Address - Phone:301-358-4447
Practice Address - Fax:240-547-0620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-20
Last Update Date:2008-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDDA-17939-07320900000X, 385HR2060X
320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child