Healthcare Provider Details

I. General information

NPI: 1174494298
Provider Name (Legal Business Name): HEALTH CARE FOR CHILDREN,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/12/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 LEWIS LN STE 101
HAVRE DE GRACE MD
21078-3758
US

IV. Provider business mailing address

PO BOX 309
ELKTON MD
21922-0309
US

V. Phone/Fax

Practice location:
  • Phone: 410-398-8899
  • Fax: 410-398-1477
Mailing address:
  • Phone: 410-398-8899
  • Fax: 410-398-1477

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. WINSTON DEQUINA
Title or Position: MANAGER
Credential:
Phone: 410-398-8899