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General NPI Number Information
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NPI Number | 1417364399
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Entity Type | Organization
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Legal Business Name | STANDARD INTEGRATED SUPPORTS INC
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Dates
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Enumeration Date | 07/12/2014
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Last Update Date | 07/12/2014
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Provider Practice Location Address
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Address Line | 600 REISTERSTOWN RD SUITE 300A
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City | PIKESVILLE
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State | MD
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Zip | 21208-5104
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Country | US
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Telephone | 410-415-7025
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Fax | 410-415-7026
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Provider Business Mailing Address
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Address Line | 600 REISTERSTOWN RD SUITE 300A
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City | PIKESVILLE
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State | MD
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Zip | 21208-5104
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Country | US
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Telephone | 410-415-7025
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Fax | 410-415-7026
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MUFU ADEKOYA
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Credential |
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Telephone | 718-812-2778
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R3586
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License Number State | MD
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