Provider Demographics
NPI:1164939054
Name:SOUTHERN MARYLAND VOCATIONAL INDUSTRIES, INC.
Entity Type:Organization
Organization Name:SOUTHERN MARYLAND VOCATIONAL INDUSTRIES, INC.
Other - Org Name:EPIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:DISALVO
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:301-516-7300
Mailing Address - Street 1:8000 PARSTON DR
Mailing Address - Street 2:
Mailing Address - City:FORESTVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20747-4428
Mailing Address - Country:US
Mailing Address - Phone:301-516-7300
Mailing Address - Fax:301-516-4146
Practice Address - Street 1:7704 MATAPEAKE BUSINESS DR STE 210
Practice Address - Street 2:
Practice Address - City:BRANDYWINE
Practice Address - State:MD
Practice Address - Zip Code:20613-3051
Practice Address - Country:US
Practice Address - Phone:301-516-7300
Practice Address - Fax:301-516-4146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-02
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDD0091251C00000X, 251S00000X, 311ZA0620X, 320900000X, 385H00000X
251E00000X, 253Z00000X, 261QA0600X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251S00000XAgenciesCommunity/Behavioral Health
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD731623200Medicaid