Healthcare Provider Details

I. General information

NPI: 1316770910
Provider Name (Legal Business Name): PACE HEALTH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2024
Last Update Date: 09/26/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8643 CHERRY LANE
LAUREL MD
20707
US

IV. Provider business mailing address

124 BROADKILL RD #1045
MILTON DE
19968-1008
US

V. Phone/Fax

Practice location:
  • Phone: 443-583-3410
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: SHANA SPENCER
Title or Position: CEO
Credential:
Phone: 443-583-3410