MEDICARE: COMMUNITY ADVOCACY 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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1922759075
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY ADVOCACY SERVICES LLC

Provider Business Mailing Address
First Line	:	PO BOX 793
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-0781
Country	:	US
Telephone Number	:	667-320-9777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2718 W NORTH AVE STE 219
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21216-3138
Country	:	US
Telephone Number	:	667-320-9777
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM DIRECTOR
Name	:	DAJAH CAMPBELL
Credential	:
Telephone Number	:	667-320-9777

Provider Enumeration Date	:	01/11/2022
Last Update Date	:	04/26/2022

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