Organization
COMMUNITY CARE DEVELOPMENTAL SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANUARY LEVERE (CEO)
(443) 418-8669
Entity
Organization
Contact information
Practice address
8101 SANDY SPRING RD STE 250M, LAUREL, MD 20707-3527
(443) 418-8669
Mailing address
8101 SANDY SPRING RD STE 250M, LAUREL, MD 20707-3527
(443) 418-8669
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1174115760
—
MD
05
—
1851664890
—
MD
Enumeration date
01/04/2022
Last updated
01/04/2022
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