Healthcare Provider Details

I. General information

NPI: 1255183711
Provider Name (Legal Business Name): ON TIME HOME HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5906 PARK HEIGHTS AVE STE 107-19
BALTIMORE MD
21215-3631
US

IV. Provider business mailing address

8700 CENTRAL AVE STE 207
LANDOVER MD
20785-4868
US

V. Phone/Fax

Practice location:
  • Phone: 301-433-8068
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBORAH AZUINE
Title or Position: OWNER
Credential:
Phone: 240-429-2874