Healthcare Provider Details

I. General information

NPI: 1497637607
Provider Name (Legal Business Name): AI COMMUNITY INITIATIVE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/21/2025
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8118 HARFORD RD # G
PARKVILLE MD
21234-5725
US

IV. Provider business mailing address

8118 HARFORD RD # G
PARKVILLE MD
21234-5725
US

V. Phone/Fax

Practice location:
  • Phone: 667-777-0097
  • Fax:
Mailing address:
  • Phone: 667-777-0097
  • 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 Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: ADELAIDE INCOOM
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 667-777-0097