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General NPI Number Information
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NPI Number | 1073967576
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Entity Type | Organization
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Legal Business Name | INHOME CARETAKERS
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Dates
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Enumeration Date | 04/20/2016
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Last Update Date | 04/20/2016
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Provider Practice Location Address
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Address Line | 406 LAKE DR
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City | LUSBY
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State | MD
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Zip | 20657-3260
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Country | US
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Telephone | 443-239-6277
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Fax |
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Provider Business Mailing Address
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Address Line | 406 LAKE DR
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City | LUSBY
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State | MD
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Zip | 20657-3260
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Country | US
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Telephone | 443-239-6277
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Fax |
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Authorized Official
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Title or Position | NONEMPLOYEE DISABLED CARETAKER RENT
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Name | MR. NAUGLE HOPE DARE
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Credential |
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Telephone | 443-239-6277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | D60062231336
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | D60062231336
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License Number State | MD
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