National Provider Identifier Database

CHANCE AT LIFE SUPPORT SERVICES
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities


Contact Information

CHANCE AT LIFE SUPPORT SERVICES
110 DUNSFORD CT
WALKERSVILLE, MD21793-8252
Phone: 443-226-9790
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for CHANCE AT LIFE SUPPORT SERVICES

NPI Number 1104542927
Legal business name
LBN
CHANCE AT LIFE SUPPORT SERVICES
Authorized official JANEL QUARLES - (EXECUTIVE DIRECTOR)
Entity Organization
Organization subpart No
Enumeration date 10/13/2022
Last updated 10/13/2022 - About 4 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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