Healthcare Provider Details

I. General information

NPI: 1548838261
Provider Name (Legal Business Name): ZIPPY CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2021
Last Update Date: 06/02/2023
Certification Date: 06/02/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3402 AURORA LN APT H
GWYNN OAK MD
21207-5742
US

IV. Provider business mailing address

PO BOX 31692
GWYNN OAK MD
21207-8692
US

V. Phone/Fax

Practice location:
  • Phone: 929-855-0686
  • Fax:
Mailing address:
  • Phone: 667-351-1853
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3104A0630X
TaxonomyAssisted Living Facility (Behavioral Disturbances)
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN ODOFIN
Title or Position: CEO
Credential:
Phone: 929-855-0686