Healthcare Provider Details

I. General information

NPI: 1629235809
Provider Name (Legal Business Name): YEMANTI NURSING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2008
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 CANNON BALL CT
ODENTON MD
21113-2654
US

IV. Provider business mailing address

1903 CANNON BALL CT
ODENTON MD
21113-2654
US

V. Phone/Fax

Practice location:
  • Phone: 410-674-8921
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberLP31111
License Number StateMD

VIII. Authorized Official

Name: MR. YAW OSEI BONSU
Title or Position: OWNER
Credential:
Phone: 410-674-8921