Healthcare Provider Details

I. General information

NPI: 1689350167
Provider Name (Legal Business Name): COMPREHENSIVE DISABILITY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 06/27/2023
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8215 FENTON ST
SILVER SPRING MD
20910-4546
US

IV. Provider business mailing address

816 THAYER AVE FL 1
SILVER SPRING MD
20910-4593
US

V. Phone/Fax

Practice location:
  • Phone: 301-755-6107
  • Fax: 301-755-6105
Mailing address:
  • Phone: 240-476-3200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VIII. Authorized Official

Name: MOYA ALICE ESTHER DJINKO
Title or Position: OWNER
Credential:
Phone: 240-476-3200