Provider Demographics
NPI:1336523729
Name:COMMUNITY OF INFINITE POSSIBILITES
Entity Type:Organization
Organization Name:COMMUNITY OF INFINITE POSSIBILITES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:AFREKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-408-8045
Mailing Address - Street 1:8304 HARFORD RD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-5700
Mailing Address - Country:US
Mailing Address - Phone:443-408-8045
Mailing Address - Fax:443-408-8050
Practice Address - Street 1:8304 HARFORD RD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-5700
Practice Address - Country:US
Practice Address - Phone:443-408-8045
Practice Address - Fax:443-408-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD251B00000X
MDNS9912022251J00000X
251S00000X, 251X00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care