Healthcare Provider Details
I. General information
NPI: 1528230562
Provider Name (Legal Business Name): CALEB ADULT DAY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/31/2008
Last Update Date: 03/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4461 FORBES BLVD
LANHAM MD
20706-4328
US
IV. Provider business mailing address
4461 FORBES BLVD
LANHAM MD
20706-4328
US
V. Phone/Fax
- Phone: 301-918-9008
- Fax: 301-918-4006
- Phone: 301-918-9008
- Fax: 301-918-4006
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QA0600X |
| Taxonomy | Adult Day Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSHUA
O.
NATHAN
SR.
Title or Position: EXECUTIVE DIRECTOR
Credential: B.S.
Phone: 301-918-9008