Provider Demographics
NPI:1720602006
Name:DYNAMIC COMMUNITY SERVICES, LLC
Entity Type:Organization
Organization Name:DYNAMIC COMMUNITY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QUALITY ASSURANCE
Authorized Official - Prefix:MR
Authorized Official - First Name:JERRELL
Authorized Official - Middle Name:L
Authorized Official - Last Name:SADDLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-329-4661
Mailing Address - Street 1:1509 BAYTREE TER
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721-2384
Mailing Address - Country:US
Mailing Address - Phone:202-779-4100
Mailing Address - Fax:
Practice Address - Street 1:1509 BAYTREE TER
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721-2384
Practice Address - Country:US
Practice Address - Phone:202-779-4100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No385H00000XRespite Care FacilityRespite Care
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child