Provider Demographics
NPI:1053663989
Name:UNIQUE HOME HEALTH CARE SERVICES, INC
Entity Type:Organization
Organization Name:UNIQUE HOME HEALTH CARE SERVICES, INC
Other - Org Name:NONE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:RHABIATU
Authorized Official - Middle Name:DAUDIATU
Authorized Official - Last Name:GAMBLE
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:301-592-7433
Mailing Address - Street 1:15511 SYMONDSBURY WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8045
Mailing Address - Country:US
Mailing Address - Phone:301-592-7433
Mailing Address - Fax:301-627-6179
Practice Address - Street 1:15511 SYMONDSBURY WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8045
Practice Address - Country:US
Practice Address - Phone:301-592-7433
Practice Address - Fax:301-627-6179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-02
Last Update Date:2012-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3179251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR3179OtherOFFICE OF HEALTH CARE QUALITY DEPARTMENT OF HEALTH