MEDICARE: DAISY'S LOVE, LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	163WH0200X	Home Health Registered Nurse
2	376K00000X	Nurse's Aide
3	385H00000X	Respite Care
4	253Z00000X	In Home Supportive Care Agency

General Provider Information

NPI Number	:	1578125795
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAISY'S LOVE, LLC

Provider Business Mailing Address
First Line	:	4405 HUNTCHASE DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-3560
Country	:	US
Telephone Number	:	833-993-2479
Fax Number	:

Provider Business Practice Location Address
First Line	:	4405 HUNTCHASE DR
Second Line	:
City	:	BOWIE
State	:	MD
Zip	:	20720-3560
Country	:	US
Telephone Number	:	202-841-3777
Fax Number	:

Authorized Official
Title or Position	:	CEO/PRESIDENT
Name	:	MRS. JOY THOMAS
Credential	:	CNA
Telephone Number	:	202-841-3777

Provider Enumeration Date	:	07/09/2019
Last Update Date	:	07/09/2019

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Directions to “DAISY'S LOVE, LLC ” Practice Location

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