Healthcare Provider Details

I. General information

NPI: 1194671131
Provider Name (Legal Business Name): CLASSICS HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8752 STONEHOUSE DR
ELLICOTT CITY MD
21043-1931
US

IV. Provider business mailing address

8752 STONEHOUSE DR
ELLICOTT CITY MD
21043-1931
US

V. Phone/Fax

Practice location:
  • Phone: 433-420-5615
  • Fax:
Mailing address:
  • Phone: 433-420-5615
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. TIMOTHY OLUWAYINKA OMOBOYE
Title or Position: PROGRAM DIRECTOR
Credential: MD
Phone: 410-772-4329