Healthcare Provider Details

I. General information

NPI: 1033751862
Provider Name (Legal Business Name): CEDAR CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2019
Last Update Date: 10/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9470 ANNAPOLIS RD STE 217
LANHAM MD
20706-3089
US

IV. Provider business mailing address

9470 ANNAPOLIS RD STE 217
LANHAM MD
20706-3089
US

V. Phone/Fax

Practice location:
  • Phone: 240-825-3166
  • Fax: 301-459-1120
Mailing address:
  • Phone: 240-825-3166
  • Fax: 301-459-1120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. OLUFEMI AFOLAYAN
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 240-825-3166