Healthcare Provider Details

I. General information

NPI: 1710821715
Provider Name (Legal Business Name): SIGNATURE HOME HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2026
Last Update Date: 04/18/2026
Certification Date: 04/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 MOONLIGHT TRAIL CT
SILVER SPRING MD
20906-6703
US

IV. Provider business mailing address

17 MOONLIGHT TRAIL CT
SILVER SPRING MD
20906-6703
US

V. Phone/Fax

Practice location:
  • Phone: 615-600-7981
  • Fax:
Mailing address:
  • Phone: 615-600-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. KALEKIRSTOS HAILEMARIAM
Title or Position: CEO
Credential: MASTERS
Phone: 615-600-7981