Healthcare Provider Details

I. General information

NPI: 1861016693
Provider Name (Legal Business Name): FIRST OPTION ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12902 OLD CHAPEL RD
BOWIE MD
20720-4616
US

IV. Provider business mailing address

12902 OLD CHAPEL RD
BOWIE MD
20720-4616
US

V. Phone/Fax

Practice location:
  • Phone: 240-334-1121
  • Fax: 240-540-4963
Mailing address:
  • Phone: 240-334-1121
  • Fax: 240-540-4963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code315D00000X
TaxonomyInpatient Hospice
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER C MADUBUKO
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-334-1121