Provider Demographics
NPI:1427637537
Name:COMMUNITY OF INFINITE POSSIBILITIES SUPPORT SERVICES LLC
Entity type:Organization
Organization Name:COMMUNITY OF INFINITE POSSIBILITIES SUPPORT SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:AFREKA
Authorized Official - Middle Name:
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-408-8045
Mailing Address - Street 1:1809 E JOPPA RD
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-2709
Mailing Address - Country:US
Mailing Address - Phone:443-408-8045
Mailing Address - Fax:443-408-8050
Practice Address - Street 1:1809 E JOPPA RD
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-2709
Practice Address - Country:US
Practice Address - Phone:443-408-8045
Practice Address - Fax:443-408-8050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-06
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No251X00000XAgenciesSupports Brokerage
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care