Healthcare Provider Details

I. General information

NPI: 1891603015
Provider Name (Legal Business Name): CARE 365 SUPPORT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22477 OLDE HEWITT RD
LEXINGTON PARK MD
20653-2068
US

IV. Provider business mailing address

22477 OLDE HEWITT RD
LEXINGTON PARK MD
20653-2068
US

V. Phone/Fax

Practice location:
  • Phone: 747-266-4198
  • Fax:
Mailing address:
  • Phone: 747-266-4198
  • 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: FAZIRAH MUTONI
Title or Position: CEO
Credential: MUTONI
Phone: 747-266-4198