MEDICARE: CONFIDENCE HEALTH SERVICES LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0401X	Comprehensive Outpatient Rehabilitation Facility (CORF)
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1629740584
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONFIDENCE HEALTH SERVICES LLC

Provider Business Mailing Address
First Line	:	219 W BEL AIR AVE
Second Line	:
City	:	ABERDEEN
State	:	MD
Zip	:	21001-3256
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	219 W BEL AIR AVE
Second Line	:
City	:	ABERDEEN
State	:	MD
Zip	:	21001-3256
Country	:	US
Telephone Number	:	443-562-6538
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MR. CHIGOZIEM EKWONYE
Credential	:
Telephone Number	:	443-562-6538

Provider Enumeration Date	:	09/29/2021
Last Update Date	:	09/29/2021

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