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General NPI Number Information
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NPI Number | 1689215766
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Entity Type | Organization
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Legal Business Name | SHALUMSTAR HOME HEALTH CARE LLC
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Dates
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Enumeration Date | 09/30/2019
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Last Update Date | 11/27/2019
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Provider Practice Location Address
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Address Line | 11360 EVANS TRL APT T4
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City | BELTSVILLE
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State | MD
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Zip | 20705-3031
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Country | US
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Telephone | 202-790-3932
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Fax |
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Provider Business Mailing Address
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Address Line | 11360 EVANS TRL APT T4
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City | BELTSVILLE
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State | MD
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Zip | 20705-3031
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Country | US
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Telephone | 202-790-3932
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | FLORE LELY MOUANG
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Credential | PATIENT CARE TECH
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Telephone | 202-790-3932
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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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