Healthcare Provider Details

I. General information

NPI: 1568845600
Provider Name (Legal Business Name): GLOBAL RESOURCES & SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 03/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 RHODE ISLAND AVE NE
WASHINGTON DC
20018-2441
US

IV. Provider business mailing address

6475 NEW HAMPSHIRE AVE STE 750
HYATTSVILLE MD
20783-3294
US

V. Phone/Fax

Practice location:
  • Phone: 443-813-9800
  • Fax:
Mailing address:
  • Phone: 443-813-9800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number StateDC

VIII. Authorized Official

Name: TONYA ALISON HEADLEY COPPIN
Title or Position: CEO
Credential: MS.ED;MS.SP.ED
Phone: 301-585-3616