Healthcare Provider Details

I. General information

NPI: 1619325834
Provider Name (Legal Business Name): AMERICAN CARE TEAM, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2016
Last Update Date: 05/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2811 FALLING BROOK TER
ADELPHI MD
20783-1451
US

IV. Provider business mailing address

2811 FALLING BROOK TER
ADELPHI MD
20783-1451
US

V. Phone/Fax

Practice location:
  • Phone: 240-581-2918
  • Fax:
Mailing address:
  • Phone: 240-581-2918
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR3891
License Number StateMD

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MRS. FATUMA NUNU ADEN
Title or Position: DIRECTOR OF NURSING
Credential: R.N.
Phone: 240-938-2457