Organization
COMMUNITY SUPPORT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK J GRAVELINE PSY.D., MHA, BCBA-D (DEPUTY DIRECTOR)
(301) 926-2300
Entity
Organization
Contact information
Practice address
9075 COMPRINT CT, GAITHERSBURG, MD 20877-1306
(301) 926-2300
Mailing address
9075 COMPRINT CT, GAITHERSBURG, MD 20877-1306
(301) 926-2300
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
0179
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1609915495
—
MD
Enumeration date
12/30/2016
Last updated
12/30/2016
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