Healthcare Provider Details

I. General information

NPI: 1760523047
Provider Name (Legal Business Name): DEERFIELD HEALTHCARE CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 BUSINESS PKWY S SUITE 60
WESTMINSTER MD
21157-3019
US

IV. Provider business mailing address

400 REDLAND CT SUITE 114
OWINGS MILLS MD
21117-3270
US

V. Phone/Fax

Practice location:
  • Phone: 410-857-0400
  • Fax: 410-857-0142
Mailing address:
  • Phone: 443-548-2200
  • Fax: 443-548-2260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: KRIS W. BALDOCK
Title or Position: CHAIRMAN, CEO, PRESIDENT
Credential:
Phone: 443-548-2201