Healthcare Provider Details

I. General information

NPI: 1023494234
Provider Name (Legal Business Name): LUCIA ROSARIO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2015
Last Update Date: 08/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2113 PLYERS MILL RD 2113 PLYERS MILL RD
SILVER SPRING MD
20902
US

IV. Provider business mailing address

2113 PLYERS MILL RD
SILVER SPRING MD
20902-4227
US

V. Phone/Fax

Practice location:
  • Phone: 301-500-7638
  • Fax:
Mailing address:
  • Phone: 301-500-7638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License NumberHHA11289
License Number StateDC

VIII. Authorized Official

Name: MRS. LUCIA ROSARIO SR.
Title or Position: HOME HEALTH AID
Credential: HHA11289
Phone: 301-500-7638