{
"Npi": {
"NPI": "1396590782",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CARE SUPPORT COMMUNITY SERVICES INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 577",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOWIE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20718-0577",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "410-826-4345",
"MailingAddressFaxNumber": "877-214-5757",
"FirstLinePracticeLocationAddress": "3010 MITCHELLVILLE RD STE 104",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BOWIE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20716-6302",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "410-826-4345",
"PracticeLocationAddressFaxNumber": "877-214-5757",
"EnumerationDate": "04/19/2024",
"LastUpdateDate": "04/19/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OWUSU ANSAH",
"AuthorizedOfficialFirstName": "MELLISA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "410-826-4345",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}