Healthcare Provider Details

I. General information

NPI: 1679262810
Provider Name (Legal Business Name): CONNECTING THE DOTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 05/04/2023
Certification Date: 05/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8015 MANDAN RD APT 103
GREENBELT MD
20770-2870
US

IV. Provider business mailing address

7135 MINSTREL WAY STE 204-M2
COLUMBIA MD
21045-5255
US

V. Phone/Fax

Practice location:
  • Phone: 301-357-0038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: MR. TRAVIS BROADDUS
Title or Position: CEO
Credential:
Phone: 301-357-0038