Healthcare Provider Details

I. General information

NPI: 1891334546
Provider Name (Legal Business Name): CARE AT HOME INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2019
Last Update Date: 12/28/2019
Certification Date: 12/28/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 WEST ST
ANNAPOLIS MD
21401-4198
US

IV. Provider business mailing address

1125 WEST ST
ANNAPOLIS MD
21401-4198
US

V. Phone/Fax

Practice location:
  • Phone: 443-768-6095
  • Fax:
Mailing address:
  • Phone: 443-768-6095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: DR. GRACE U EKPENYONG
Title or Position: ADMINISTRATOR
Credential: ADMINISTRATOR
Phone: 443-768-6095