Provider Demographics
NPI:1144070343
Name:SUPPORT SERVICES OF MARYLAND CORPORATION
Entity type:Organization
Organization Name:SUPPORT SERVICES OF MARYLAND CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:INNOCENT
Authorized Official - Middle Name:
Authorized Official - Last Name:AKPUAKA
Authorized Official - Suffix:
Authorized Official - Credentials:REGISTERED NURSE, BS
Authorized Official - Phone:410-984-7411
Mailing Address - Street 1:6817 REAL PRINCESS LN
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-4493
Mailing Address - Country:US
Mailing Address - Phone:410-984-7411
Mailing Address - Fax:
Practice Address - Street 1:4002 W BELVEDERE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5502
Practice Address - Country:US
Practice Address - Phone:410-984-7411
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-22
Last Update Date:2024-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care