Healthcare Provider Details

I. General information

NPI: 1700058906
Provider Name (Legal Business Name): PASSIONATE HEALTHCARE SERVICES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 07/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 RESERVE CIR SUITE 303
BALTIMORE MD
21244-1605
US

IV. Provider business mailing address

PO BOX 47224
WINDSOR MILL MD
21244-0224
US

V. Phone/Fax

Practice location:
  • Phone: 410-298-9234
  • Fax: 410-298-9234
Mailing address:
  • Phone: 410-660-5925
  • Fax: 410-298-9234

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number0707008 NURSINGSTAFF
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR2695R (RSA)
License Number StateMD

VIII. Authorized Official

Name: MS. DORIS A BEN
Title or Position: COO
Credential: RN
Phone: 410-660-5925