Healthcare Provider Details

I. General information

NPI: 1598606782
Provider Name (Legal Business Name): BLUE HERON HOMECARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 RITCHIE HWY STE 110
ARNOLD MD
21012-2704
US

IV. Provider business mailing address

1460 RITCHIE HWY STE 110
ARNOLD MD
21012-2704
US

V. Phone/Fax

Practice location:
  • Phone: 410-995-2211
  • Fax: 410-779-3566
Mailing address:
  • Phone: 410-995-2211
  • Fax: 410-779-3566

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JIM THOMASSON
Title or Position: PRESIDENT/OWNER
Credential:
Phone: 410-779-9721