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Organization
LIFELONG SUPPORT INC
Active
Organization
LIFELONG SUPPORT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NWANNE UMAZI UDEAGHA (EXECUTIVE PROGRAM DIRECTOR)
(202) 615-9100
Entity
Organization
Contact information
Practice address
14709 SUSAN MARIE WAY, WOODBINE, MD 21797-8617
(202) 615-9100
Mailing address
14709 SUSAN MARIE WAY, WOODBINE, MD 21797-8617
(202) 615-9100
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
—
251J00000X
Nursing Care Agency
—
—
253Z00000X
In Home Supportive Care Agency
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
11/17/2025
Last updated
11/17/2025
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