Healthcare Provider Details

I. General information

NPI: 1043987522
Provider Name (Legal Business Name): RESPONSE SENIOR CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2021
Last Update Date: 08/24/2021
Certification Date: 08/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 OLD SOLOMONS ISLAND RD STE B
ANNAPOLIS MD
21401-4181
US

IV. Provider business mailing address

31 OLD SOLOMONS ISLAND RD STE B
ANNAPOLIS MD
21401-4181
US

V. Phone/Fax

Practice location:
  • Phone: 410-571-2744
  • Fax:
Mailing address:
  • Phone: 410-571-2744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: SAMANTHA MOYER
Title or Position: OWNER
Credential:
Phone: 410-571-2744