Provider Demographics
NPI:1013591643
Name:GEM HOME CARE , LLC
Entity Type:Organization
Organization Name:GEM HOME CARE , LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VILDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DESGOUTTEBROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-338-5170
Mailing Address - Street 1:13247 WINDSONG LN
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20871-5302
Mailing Address - Country:US
Mailing Address - Phone:240-338-5170
Mailing Address - Fax:
Practice Address - Street 1:13247 WINDSONG LN
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:MD
Practice Address - Zip Code:20871-5302
Practice Address - Country:US
Practice Address - Phone:240-338-5170
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-10
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health