Healthcare Provider Details

I. General information

NPI: 1386424018
Provider Name (Legal Business Name): PLATINUM SENIORS CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 03/05/2024
Certification Date: 03/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10770 COLUMBIA PIKE STE 300E-28
SILVER SPRING MD
20901-4402
US

IV. Provider business mailing address

10770 COLUMBIA PIKE STE 300E-28
SILVER SPRING MD
20901-4402
US

V. Phone/Fax

Practice location:
  • Phone: 301-476-1621
  • Fax:
Mailing address:
  • Phone: 301-476-1621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome 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: DR. JACQUES JULES NOUMSI
Title or Position: CEO
Credential:
Phone: 240-643-4615