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General NPI Number Information
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NPI Number | 1568992386
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Entity Type | Organization
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Legal Business Name | EXTRA CARE HOME HEALTH INC
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/14/2017
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Provider Practice Location Address
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Address Line | 5602 BALTIMORE NATIONAL PIKE STE 700
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City | CATONSVILLE
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State | MD
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Zip | 21228-1408
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Country | US
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Telephone | 443-315-5143
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Fax | 443-315-5345
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Provider Business Mailing Address
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Address Line | 5602 BALTIMORE NATIONAL PIKE STE 700
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City | CATONSVILLE
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State | MD
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Zip | 21228-1408
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Country | US
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Telephone | 443-315-5143
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Fax | 443-315-5345
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Authorized Official
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Title or Position | PRESIDENT
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Name | ABAYOMI GEOFFREY AJEPE
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Credential |
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Telephone | 443-315-5143
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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 | R4111P
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License Number State | MD
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