MEDICARE: DEDICATED CARE SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1235020306
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEDICATED CARE SERVICES LLC

Provider Business Mailing Address
First Line	:	13606 OAKLANDS MANOR DR
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1429
Country	:	US
Telephone Number	:	443-629-1456
Fax Number	:

Provider Business Practice Location Address
First Line	:	13606 OAKLANDS MANOR DR
Second Line	:
City	:	LAUREL
State	:	MD
Zip	:	20708-1429
Country	:	US
Telephone Number	:	443-629-1456
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. ALICE A EYONG
Credential	:	DPT
Telephone Number	:	443-629-1456

Provider Enumeration Date	:	07/15/2025
Last Update Date	:	07/15/2025

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