Healthcare Provider Details

I. General information

NPI: 1629415385
Provider Name (Legal Business Name): VISION ONE HOME HEALTH AID
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/04/2013
Last Update Date: 06/04/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 LIBERTY PL APT 14
WINDSOR MILL MD
21244-2793
US

IV. Provider business mailing address

10 LIBERTY PL APT 14
WINDSOR MILL MD
21244-2793
US

V. Phone/Fax

Practice location:
  • Phone: 443-447-2378
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1268912
License Number StateDC

VIII. Authorized Official

Name: MISS ROLANDE MEUMELIEU
Title or Position: HOME HEALTH AID
Credential:
Phone: 443-447-2378