Provider Demographics
NPI:1033751862
Name:CEDAR CARE, LLC
Entity Type:Organization
Organization Name:CEDAR CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OLUFEMI
Authorized Official - Middle Name:
Authorized Official - Last Name:AFOLAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-825-3166
Mailing Address - Street 1:9470 ANNAPOLIS RD STE 217
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3089
Mailing Address - Country:US
Mailing Address - Phone:240-825-3166
Mailing Address - Fax:301-459-1120
Practice Address - Street 1:9470 ANNAPOLIS RD STE 217
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3089
Practice Address - Country:US
Practice Address - Phone:240-825-3166
Practice Address - Fax:301-459-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD56200095-00Medicaid