Healthcare Provider Details

I. General information

NPI: 1619749736
Provider Name (Legal Business Name): IT TAKES A FAMILY- IN HOME MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 7TH ST STE 301
LAUREL MD
20707-3959
US

IV. Provider business mailing address

603 7TH ST STE 301
LAUREL MD
20707-3959
US

V. Phone/Fax

Practice location:
  • Phone: 856-454-5100
  • Fax:
Mailing address:
  • Phone: 856-454-5100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: ADEKEMI ADELAKUN-PINHEIRO
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 609-933-7044