Healthcare Provider Details

I. General information

NPI: 1285583211
Provider Name (Legal Business Name): FM COMMUNITY CONNECT CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2026
Last Update Date: 01/23/2026
Certification Date: 01/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 GUILFORD DR STE 200
FREDERICK MD
21704-5264
US

IV. Provider business mailing address

7100 GUILFORD DR STE 200
FREDERICK MD
21704-5264
US

V. Phone/Fax

Practice location:
  • Phone: 240-667-6064
  • Fax:
Mailing address:
  • Phone: 240-667-6064
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: AILEEN MALOU
Title or Position: RN
Credential: REGISTERED NURSE
Phone: 240-667-6664