Healthcare Provider Details

I. General information

NPI: 1417568171
Provider Name (Legal Business Name): A NEW WALK OF LIFE HEALTH CARE AGENCY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 08/01/2023
Certification Date: 08/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1107 N POINT BLVD STE 227
BALTIMORE MD
21224-3470
US

IV. Provider business mailing address

1107 N POINT BLVD
BALTIMORE MD
21224-3420
US

V. Phone/Fax

Practice location:
  • Phone: 410-213-5154
  • Fax: 410-779-3794
Mailing address:
  • Phone: 410-213-5154
  • Fax: 410-779-3794

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: CHERYLITA RICHARDSON
Title or Position: OWNER/PRESIDENT
Credential:
Phone: 410-213-5154