Provider Demographics
NPI:1215732771
Name:COMPASSION COMMUNITY SERVICES, INC
Entity type:Organization
Organization Name:COMPASSION COMMUNITY SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:
Authorized Official - Last Name:KIBANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-413-1428
Mailing Address - Street 1:963 RUSSELL AVE STE D
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20879-3287
Mailing Address - Country:US
Mailing Address - Phone:240-413-1428
Mailing Address - Fax:240-386-1197
Practice Address - Street 1:963 RUSSELL AVE STE D963
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20879-3287
Practice Address - Country:US
Practice Address - Phone:240-413-1428
Practice Address - Fax:240-386-1197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities