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General NPI Number Information
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NPI Number | 1043563380
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Entity Type | Organization
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Legal Business Name | JOURNEYS EMBRACED LLC
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Dates
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Enumeration Date | 10/24/2012
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Last Update Date | 10/24/2012
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Provider Practice Location Address
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Address Line | 314 SKY BLUE CT
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City | EDGEWOOD
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State | MD
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Zip | 21040-3120
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Country | US
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Telephone | 443-794-5880
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Fax |
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Provider Business Mailing Address
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Address Line | 314 SKY BLUE CT
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City | EDGEWOOD
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State | MD
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Zip | 21040-3120
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Country | US
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Telephone | 443-794-5880
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Fax |
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Authorized Official
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Title or Position | MEMBER/OWNER
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Name | MS. TRINNA D JONES
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Credential | RN
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Telephone | 443-794-5880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number | R120966
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License Number State | MD
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