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General NPI Number Information
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NPI Number | 1083202642
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Entity Type | Organization
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Legal Business Name | COMPLETE CARE SUPPORT SERVICES INC
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Dates
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Enumeration Date | 01/08/2021
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 5602 BALTIMORE NATIONAL PIKE STE 306
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City | CATONSVILLE
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State | MD
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Zip | 21228-1410
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Country | US
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Telephone | 410-521-1600
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Fax | 410-916-7946
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Provider Business Mailing Address
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Address Line | 5602 BALTIMORE NATIONAL PIKE STE 306
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City | CATONSVILLE
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State | MD
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Zip | 21228-1410
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Country | US
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Telephone | 410-521-1600
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Fax |
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Authorized Official
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Title or Position | ADMIN
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Name | MR. JAY JAY
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Credential |
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Telephone | 410-521-1600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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