=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235746363
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ADMIRED HOME HEALTHCARE SOLUTIONS, LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/23/2020
-----------------------------------------------------
Last Update Date | 09/23/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9101 CHERRY LN STE 212
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-1116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-994-3896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9101 CHERRY LN STE 212
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-1116
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-994-3896
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINICAL ADMINSITRATOR
-----------------------------------------------------
Name | JENKAA CECILE DZEKASHU
-----------------------------------------------------
Credential | PHARMACIST
-----------------------------------------------------
Telephone | 240-994-3896
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------