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NPI Code Detail

MEDICARE: CARNELIAN GROUP LLC

MEDICARE: CARNELIAN GROUP LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1558239079
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARNELIAN GROUP LLC
Provider Business Mailing Address
First Line : 3261 OLD WASHINGTON RD STE 2031
Second Line :
City : WALDORF
State : MD
Zip : 20602-3313
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3261 OLD WASHINGTON RD STE 2031
Second Line :
City : WALDORF
State : MD
Zip : 20602-3313
Country : US
Telephone Number : 816-217-2023
Fax Number :
Authorized Official
Title or Position : CEO
Name : KATHERINE MASSINGALE
Credential :
Telephone Number : 816-217-2023
Provider Enumeration Date : 10/27/2025
Last Update Date : 10/27/2025

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Directions to “CARNELIAN GROUP LLC ” Practice Location

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