Healthcare Provider Details

I. General information

NPI: 1164939054
Provider Name (Legal Business Name): SOUTHERN MARYLAND VOCATIONAL INDUSTRIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2018
Last Update Date: 09/12/2025
Certification Date: 09/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7704 MATAPEAKE BUSINESS DR STE 210
BRANDYWINE MD
20613-3051
US

IV. Provider business mailing address

8000 PARSTON DR
FORESTVILLE MD
20747-4428
US

V. Phone/Fax

Practice location:
  • Phone: 301-516-7300
  • Fax: 301-516-4146
Mailing address:
  • Phone: 301-516-7300
  • Fax: 301-516-4146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License NumberDD0091
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License NumberDD0091
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State
# 6
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberDD0091
License Number StateMD
# 7
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberDD0091
License Number StateMD
# 8
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State
# 9
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License NumberDD0091
License Number StateMD

VIII. Authorized Official

Name: MR. FRANCIS JAMES DISALVO
Title or Position: CFO
Credential: CPA
Phone: 301-516-7300