Healthcare Provider Details

I. General information

NPI: 1578077137
Provider Name (Legal Business Name): WORLDSHINE CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/18/2017
Last Update Date: 11/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5801 AMMENDALE RD
BELTSVILLE MD
20705-1264
US

IV. Provider business mailing address

20420 CENTURY BLVD
GERMANTOWN MD
20874-1174
US

V. Phone/Fax

Practice location:
  • Phone: 240-899-4898
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. QILI LI
Title or Position: MANAGING MEMBER
Credential:
Phone: 240-899-4898