Healthcare Provider Details

I. General information

NPI: 1720689953
Provider Name (Legal Business Name): BASILIA DAMEIDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 WOODLAND CT APT 303
LAUREL MD
20707-4527
US

IV. Provider business mailing address

2 WOODLAND CT APT 303
LAUREL MD
20707-4527
US

V. Phone/Fax

Practice location:
  • Phone: 240-640-7714
  • Fax:
Mailing address:
  • Phone: 240-640-7714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA15771
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: