Provider Demographics
NPI:1255468633
Name:COMMUNITY SUPPORT SERVICES FOR THE DEAF, INC.
Entity Type:Organization
Organization Name:COMMUNITY SUPPORT SERVICES FOR THE DEAF, INC.
Other - Org Name:CSSD, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:M.
Authorized Official - Middle Name:MAUREEN
Authorized Official - Last Name:SHANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-597-8780
Mailing Address - Street 1:2603 N ROLLING RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21244-1975
Mailing Address - Country:US
Mailing Address - Phone:410-597-8788
Mailing Address - Fax:410-597-8787
Practice Address - Street 1:2603 N ROLLING RD
Practice Address - Street 2:SUITE 301
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-1975
Practice Address - Country:US
Practice Address - Phone:410-597-8788
Practice Address - Fax:410-597-8787
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0036216320600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE81630Medicare UPIN
MD751DMedicare ID - Type UnspecifiedPSYCHIATRIST