Provider Demographics
NPI:1083212153
Name:DEPENDABLE CARE
Entity Type:Organization
Organization Name:DEPENDABLE CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHANTA
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:CNA
Authorized Official - Phone:240-309-0770
Mailing Address - Street 1:1114 MUSKOGEE LN
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-3529
Mailing Address - Country:US
Mailing Address - Phone:240-309-0770
Mailing Address - Fax:
Practice Address - Street 1:1114 MUSKOGEE LN
Practice Address - Street 2:
Practice Address - City:LUSBY
Practice Address - State:MD
Practice Address - Zip Code:20657-3529
Practice Address - Country:US
Practice Address - Phone:240-309-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health