Healthcare Provider Details

I. General information

NPI: 1750198982
Provider Name (Legal Business Name): HOLY HOME HEALTH CARE, LLC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2024
Last Update Date: 12/11/2024
Certification Date: 12/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6800 LIBERTY RD
BALTIMORE MD
21207-5831
US

IV. Provider business mailing address

6800 LIBERTY RD APT 501
BALTIMORE MD
21207
US

V. Phone/Fax

Practice location:
  • Phone: 443-379-9213
  • Fax:
Mailing address:
  • Phone: 443-379-9213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. TESSIGA SORO
Title or Position: OWNER
Credential:
Phone: 443-379-9213