OrganizationActive
Immaculate Supported Services, LLC
NPI 1265131171 · Developmental Disabilities Clinic/Center · Lanham, MD
Provider details
- NPI number
- 1265131171
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Olumide Akinola, Chief Executive Officer(302) 450-8848
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Established profile(59/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9133 Lanham Severn Rd
Lanham, MD 20706-2915
Phone: (302) 450-8848
Street-level locationGet directions
Mailing address
9133 Lanham Severn Rd
Lanham, MD 20706-2915
Registry dates
- Enumerated
- 2023-02-28
- Last updated
- 2023-02-28
- Certified
- 2023-02-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.