Provider Demographics
NPI:1295976306
Name:DEVELOPMENTAL SUPPORT ASSOCIATES, LLC
Entity type:Organization
Organization Name:DEVELOPMENTAL SUPPORT ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/MEMBER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:NORWOOD
Authorized Official - Last Name:RATHBONE
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC, CCBT
Authorized Official - Phone:301-495-2820
Mailing Address - Street 1:PO BOX 7682
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20907-7682
Mailing Address - Country:US
Mailing Address - Phone:301-588-7228
Mailing Address - Fax:877-394-5106
Practice Address - Street 1:2929 NELSON PL SE
Practice Address - Street 2:APT. 2
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-7717
Practice Address - Country:US
Practice Address - Phone:202-545-1999
Practice Address - Fax:877-394-5106
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health