Healthcare Provider Details

I. General information

NPI: 1306348727
Provider Name (Legal Business Name): EBED COMMUNITY IMPROVEMENT INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2018
Last Update Date: 03/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 CARAWAY COURT, SUITE 1070
LARGO MD
20774
US

IV. Provider business mailing address

1220 CARAWAY COURT, SUITE 1070
LARGO MD
20774
US

V. Phone/Fax

Practice location:
  • Phone: 301-306-1050
  • Fax: 410-994-3102
Mailing address:
  • Phone: 301-306-1050
  • Fax: 410-994-3102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MRS. RHONDA ALANE GRAHAM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 301-306-1050