Healthcare Provider Details

I. General information

NPI: 1770045908
Provider Name (Legal Business Name): HOMESAFE FOR SENIORS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2019
Last Update Date: 04/05/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5908 EDNA AVE
BALTIMORE MD
21214-1805
US

IV. Provider business mailing address

4901 HARFORD ROAD, #3524
BALTIMORE MD
21214
US

V. Phone/Fax

Practice location:
  • Phone: 443-473-2030
  • Fax:
Mailing address:
  • Phone: 443-473-2030
  • 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: AMY YOUNG
Title or Position: OWNER
Credential: OTR/L, CEAC, CAPS
Phone: 443-473-2030