=====================================================
General NPI Number Information
=====================================================
NPI Number | 1336730332
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | COMMCENTRIX HOME CARE SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2021
-----------------------------------------------------
Last Update Date | 02/01/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9420 ANNAPOLIS RD STE 212
-----------------------------------------------------
City | LANHAM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20706-3066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-779-3767
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9420 ANNAPOLIS RD STE 212
-----------------------------------------------------
City | LANHAM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20706-3066
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-779-3767
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | ABAYOMI SOKOYA
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 240-779-3767
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3140N1450X
-----------------------------------------------------
Taxonomy Name | Pediatric Skilled Nursing Facility
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 251J00000X
-----------------------------------------------------
Taxonomy Name | Nursing Care Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------