Provider Demographics
NPI:1417665217
Name:KLEDS COMMUNITY SUPPORT SERVICES, LLC
Entity Type:Organization
Organization Name:KLEDS COMMUNITY SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEDO
Authorized Official - Suffix:
Authorized Official - Credentials:RN, MSN, DNP
Authorized Official - Phone:240-491-1087
Mailing Address - Street 1:18909 EBBTIDE CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-1993
Mailing Address - Country:US
Mailing Address - Phone:240-491-1087
Mailing Address - Fax:
Practice Address - Street 1:18909 EBBTIDE CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-1993
Practice Address - Country:US
Practice Address - Phone:240-491-1087
Practice Address - Fax:240-252-2171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-10
Last Update Date:2022-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities