Healthcare Provider Details

I. General information

NPI: 1598449365
Provider Name (Legal Business Name): HOMSI SENIOR CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/12/2023
Last Update Date: 09/27/2023
Certification Date: 09/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6701 DEMOCRACY BLVD STE 300
BETHESDA MD
20817-7500
US

IV. Provider business mailing address

12309 VILLAGE SQUARE TER APT 201
ROCKVILLE MD
20852-1941
US

V. Phone/Fax

Practice location:
  • Phone: 800-681-5657
  • Fax:
Mailing address:
  • Phone: 240-423-9991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License Number
License Number StateNULL

VIII. Authorized Official

Name: STEVE TCHOUPE HOMSI
Title or Position: PROGRAM ADMINISTRATOR
Credential:
Phone: 301-675-0590