Provider Demographics
NPI:1770053183
Name:IBIS COMMUNITY SERVICES LLC
Entity type:Organization
Organization Name:IBIS COMMUNITY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEEGOBIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-915-5588
Mailing Address - Street 1:1738 ELTON RD STE 200B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1725
Mailing Address - Country:US
Mailing Address - Phone:240-784-7640
Mailing Address - Fax:301-650-5729
Practice Address - Street 1:1738 ELTON RD STE 200B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1725
Practice Address - Country:US
Practice Address - Phone:240-784-7640
Practice Address - Fax:301-650-5729
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:IBIS INDUSTRIES INTERNATIONAL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No172A00000XOther Service ProvidersDriverGroup - Single Specialty
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Single Specialty
No251E00000XAgenciesHome HealthGroup - Single Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Single Specialty
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child