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General NPI Number Information
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NPI Number | 1932523008
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Entity Type | Organization
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Legal Business Name | TEMAH HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 09/23/2019
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Provider Practice Location Address
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Address Line | 5310 OLD COURT RD STE 303
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-6202
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Country | US
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Telephone | 410-521-8000
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Fax | 410-655-5826
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Provider Business Mailing Address
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Address Line | 5310 OLD COURT RD STE 303
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City | RANDALLSTOWN
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State | MD
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Zip | 21133-6202
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Country | US
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Telephone | 410-702-5397
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Fax | 410-655-5826
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. GBENGA WILLIAMS
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Credential |
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Telephone | 410-521-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R3573
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License Number State | MD
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