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General NPI Number Information
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NPI Number | 1427786359
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Entity Type | Organization
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Legal Business Name | MERRY STARS INC.
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Dates
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Enumeration Date | 08/09/2022
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Last Update Date | 08/09/2022
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Provider Practice Location Address
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Address Line | 3524 CARRIAGE HILL CIR APT 203
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2961
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Country | US
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Telephone | 240-879-7479
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Fax |
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Provider Business Mailing Address
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Address Line | 3524 CARRIAGE HILL CIR APT 203
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-2961
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Country | US
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Telephone | 240-879-7479
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Fax |
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Authorized Official
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Title or Position | PROGRAM ADMINISTRATOR
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Name | AYOMIKUN FABUNMI
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Credential |
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Telephone | 240-879-7479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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