Healthcare Provider Details

I. General information

NPI: 1497373716
Provider Name (Legal Business Name): RESCUING HEARTS HOMECARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2020
Last Update Date: 07/13/2020
Certification Date: 07/13/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

713 W PRATT ST
BALTIMORE MD
21201-1023
US

IV. Provider business mailing address

713 W PRATT ST
BALTIMORE MD
21201-1023
US

V. Phone/Fax

Practice location:
  • Phone: 443-941-6063
  • Fax:
Mailing address:
  • Phone: 443-941-6063
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MS. TAVONIA STACKHOUSE
Title or Position: OWNER/CLINICAL ADMINISTRATOR
Credential:
Phone: 443-941-6063