Healthcare Provider Details

I. General information

NPI: 1740177237
Provider Name (Legal Business Name): R.E.A.M LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 HAWKS LANDING CT
WALDORF MD
20601-3274
US

IV. Provider business mailing address

12110 CHIP SHOT LN
UPPER MARLBORO MD
20772-7958
US

V. Phone/Fax

Practice location:
  • Phone: 240-398-7279
  • Fax: 240-939-3050
Mailing address:
  • Phone: 240-398-7279
  • Fax: 240-272-7114

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: MR. VASHON HARGROVE
Title or Position: PRESIDENT/EXECUTIVE DIRECTOR
Credential:
Phone: 240-398-7279