Healthcare Provider Details

I. General information

NPI: 1851213078
Provider Name (Legal Business Name): DAKARI SOUL FOOD RESTAURANT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EDGEWOOD RD
EDGEWOOD MD
21040-3309
US

IV. Provider business mailing address

300 EDGEWOOD RD
EDGEWOOD MD
21040-3309
US

V. Phone/Fax

Practice location:
  • Phone: 410-702-9828
  • Fax:
Mailing address:
  • Phone: 410-702-9828
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332U00000X
TaxonomyHome Delivered Meals
License Number
License Number State

VIII. Authorized Official

Name: ROBERT BROOKS
Title or Position: CEO
Credential:
Phone: 443-416-2345