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General NPI Number Information
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NPI Number | 1992461578
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Entity Type | Organization
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Legal Business Name | ABUNDANT CARE TEAM HOME HEALTH SERVICES
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/09/2021
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Provider Practice Location Address
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Address Line | 13607 GENTRY CT
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City | LAUREL
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State | MD
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Zip | 20708-1330
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Country | US
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Telephone | 301-776-2054
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Fax | 301-776-2054
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Provider Business Mailing Address
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Address Line | 13607 GENTRY CT
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City | LAUREL
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State | MD
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Zip | 20708-1330
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Country | US
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Telephone | 301-776-2054
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Fax | 301-776-2054
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Authorized Official
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Title or Position | OWNER
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Name | FOLASADE OLUREMI FATUSIN
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Credential |
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Telephone | 240-475-0376
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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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