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NPI 1285321901

NPI 1285321901 : ABOVECARE COMMUNITY SERVICES INC : REISTERSTOWN, MD

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General NPI Number Information
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    NPI Number           |    1285321901
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    Entity Type          |    Organization 
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    Legal Business Name  |    ABOVECARE COMMUNITY SERVICES INC 
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Dates
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    Enumeration Date     |    04/21/2023
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    Last Update Date     |    04/28/2023
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Provider Practice Location Address
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    Address Line         |    36 FALLS CHAPEL WAY 
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    City                 |    REISTERSTOWN
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    State                |    MD
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    Zip                  |    21136-3653
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    Country              |    US
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    Telephone            |    410-830-0061
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    36 FALLS CHAPEL WAY 
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    City                 |    REISTERSTOWN
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    State                |    MD
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    Zip                  |    21136-3653
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    Country              |    US
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    Telephone            |    410-830-0061
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    Fax                  |    
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Authorized Official
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    Title or Position    |    ADMINISTRATOR
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    Name                 |     OLA  OLUKANNI 
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    Credential           |    
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    Telephone            |    410-830-0061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    320900000X
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    Taxonomy Name        |    Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    385HR2060X
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    Taxonomy Name        |    Child Intellectual and/or Developmental Disabilities Respite Care
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    251S00000X
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    Taxonomy Name        |    Community/Behavioral Health Agency
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    License Number       |    
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    License Number State |    
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