Provider Demographics
NPI:1427744028
Name:EDUCARE SUPPORT SERVICES, INC
Entity type:Organization
Organization Name:EDUCARE SUPPORT SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF 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:CPRP, CAMS-I, 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:240-450-2092
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:240-450-2092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-17
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)