Provider Demographics
NPI:1104363464
Name:N3O HOMECARE, LLC
Entity Type:Organization
Organization Name:N3O HOMECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BASIRU
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAMBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-284-0636
Mailing Address - Street 1:9701 APOLLO DR
Mailing Address - Street 2:SUITE 330
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-4783
Mailing Address - Country:US
Mailing Address - Phone:301-358-2804
Mailing Address - Fax:301-542-0184
Practice Address - Street 1:9701 APOLLO DR
Practice Address - Street 2:SUITE 330
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-4783
Practice Address - Country:US
Practice Address - Phone:301-358-2804
Practice Address - Fax:301-542-0184
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:N3O ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-01-25
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3887251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR3887OtherSTATE LICENSE