=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861769390
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | VAUGHAN HOME CARE SERVICES,INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/29/2011
-----------------------------------------------------
Last Update Date | 11/29/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1906 SUMMIT AVE
-----------------------------------------------------
City | ROSEDALE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21237-1332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-559-6097
-----------------------------------------------------
Fax | 443-559-6188
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1906 SUMMIT AVE
-----------------------------------------------------
City | ROSEDALE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21237-1332
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-559-6097
-----------------------------------------------------
Fax | 443-559-6188
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/ADMINISTRATOR
-----------------------------------------------------
Name | MRS. ANNE OSEI
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 443-559-6097
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | R3062
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------