Healthcare Provider Details

I. General information

NPI: 1497016075
Provider Name (Legal Business Name): EXCEED HOME CARE SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2012
Last Update Date: 05/31/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 LOMOND CT
BALTIMORE MD
21237-4523
US

IV. Provider business mailing address

19 LOMOND CT
BALTIMORE MD
21237-4523
US

V. Phone/Fax

Practice location:
  • Phone: 410-238-3179
  • Fax: 410-238-3821
Mailing address:
  • Phone: 410-238-3179
  • Fax: 410-238-3821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR3059
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License NumberR3059
License Number StateMD

VIII. Authorized Official

Name: MR. EGBUNINE FRANK OKECHUKWU
Title or Position: DIRECTOR
Credential: BSN, RN
Phone: 410-238-3179