MEDICARE: S AND C UNITED CARE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	251E00000X	Home Health Agency
2	253Z00000X	In Home Supportive Care Agency
3	3104A0630X	Assisted Living Facility (Behavioral Disturbances)
4	310500000X	Mental Illness Intermediate Care Facility
5	320800000X	Mental Illness Community Based Residential Treatment Facility	DC
6	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
7	332B00000X	Durable Medical Equipment & Medical Supplies
8	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1518461599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S AND C UNITED CARE SERVICES INC

Provider Business Mailing Address
First Line	:	11005 TULIP HILL LN
Second Line	:
City	:	UPPER MARLBORO
State	:	MD
Zip	:	20772-3974
Country	:	US
Telephone Number	:	301-806-4791
Fax Number	:	202-204-5789

Provider Business Practice Location Address
First Line	:	6507 VALLEY PARK RD
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-2571
Country	:	US
Telephone Number	:	301-806-4791
Fax Number	:	202-204-5789

Authorized Official
Title or Position	:	DIRECTOR
Name	:	LATONJA DESHAWN CARRERA
Credential	:	PHD
Telephone Number	:	301-806-4791

Provider Enumeration Date	:	03/22/2018
Last Update Date	:	03/22/2018

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Directions to “S AND C UNITED CARE SERVICES INC ” Practice Location

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