Provider Demographics
NPI:1831742451
Name:EDUCARE COMMUNTIY SUPPORT SERVICES, LLC
Entity type:Organization
Organization Name:EDUCARE COMMUNTIY SUPPORT SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:DUNRICK
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:SOGIE-THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:301-850-8999
Mailing Address - Street 1:1007 LARCH AVE
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6520
Mailing Address - Country:US
Mailing Address - Phone:301-920-0121
Mailing Address - Fax:
Practice Address - Street 1:1007 LARCH AVE
Practice Address - Street 2:
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6520
Practice Address - Country:US
Practice Address - Phone:301-920-0121
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-23
Last Update Date:2023-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness