National Provider Identifier Database

FORMA CARE 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

FORMA CARE SERVICES
39 E FRANKLIN ST STE C
HAGERSTOWN, MD21740-4914
Phone: 240-543-5972
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities 320900000X

* Indicates primary specialty

NPI Profile & details for FORMA CARE SERVICES

NPI Number 1396599098
Legal business name
LBN
FORMA CARE SERVICES
Authorized official OLUWASEUN OGUNLEYE - (FOUNDER)
Entity Organization
Organization subpart No
Enumeration date 04/17/2024
Last updated 05/28/2024 - About 2 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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