Healthcare Provider Details

I. General information

NPI: 1609703859
Provider Name (Legal Business Name): SHADES PLACE ASSISTED LIVING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2306 ECHODALE AVE
BALTIMORE MD
21214-1930
US

IV. Provider business mailing address

2306 ECHODALE AVE
BALTIMORE MD
21214-1930
US

V. Phone/Fax

Practice location:
  • Phone: 443-931-9618
  • Fax:
Mailing address:
  • Phone: 443-931-9618
  • Fax:

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: MOROHUNKEJI O AJANAKU
Title or Position: OWNER
Credential:
Phone: 443-931-9618