Healthcare Provider Details

I. General information

NPI: 1295876787
Provider Name (Legal Business Name): ADULT MEDICAL DAYCARE OF HOMELAND
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5800 BELAIR RD
BALTIMORE MD
21206-2607
US

IV. Provider business mailing address

6401 DOGWOOD RD STE 108
BALTIMORE MD
21207-5248
US

V. Phone/Fax

Practice location:
  • Phone: 410-444-5800
  • Fax: 410-444-6663
Mailing address:
  • Phone: 410-298-9800
  • Fax: 410-298-5206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JOSEPH EDWARD DEVEDOSS
Title or Position: PRESIDENT
Credential:
Phone: 410-298-9800