Healthcare Provider Details

I. General information

NPI: 1487572947
Provider Name (Legal Business Name): MULTIPLE CARE & COMMUNITY SUPPORT SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5338 REISTERSTOWN RD
BALTIMORE MD
21215-4426
US

IV. Provider business mailing address

5338 REISTERSTOWN RD
BALTIMORE MD
21215-4426
US

V. Phone/Fax

Practice location:
  • Phone: 443-356-7128
  • Fax:
Mailing address:
  • Phone: 443-356-7128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code315P00000X
TaxonomyIntellectual Disabilities Intermediate Care Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: OMODELE OLAWOLE
Title or Position: CEO
Credential: PMHNP-BC
Phone: 443-356-7128