Provider Demographics
NPI:1083927735
Name:SAINT PAUL'S NURSING CARE, LLC
Entity Type:Organization
Organization Name:SAINT PAUL'S NURSING CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:ACKAH
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-476-5756
Mailing Address - Street 1:7100 MUNCASTER MILL RD
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-1213
Mailing Address - Country:US
Mailing Address - Phone:240-476-5756
Mailing Address - Fax:240-477-4244
Practice Address - Street 1:7100 MUNCASTER MILL RD
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-1213
Practice Address - Country:US
Practice Address - Phone:240-476-5756
Practice Address - Fax:240-477-4244
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-23
Last Update Date:2010-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2933P251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care