Provider Demographics
NPI:1164708160
Name:YOUR BEST WAY HOME, ALF
Entity Type:Organization
Organization Name:YOUR BEST WAY HOME, ALF
Other - Org Name:YOUR BEST WAY HOME, ALF
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:MATTIS-MYRIE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-821-9600
Mailing Address - Street 1:3625 CEDAR DR
Mailing Address - Street 2:
Mailing Address - City:GWYNN OAK
Mailing Address - State:MD
Mailing Address - Zip Code:21207-6306
Mailing Address - Country:US
Mailing Address - Phone:410-821-9600
Mailing Address - Fax:410-821-3790
Practice Address - Street 1:3625 CEDAR DR
Practice Address - Street 2:
Practice Address - City:GWYNN OAK
Practice Address - State:MD
Practice Address - Zip Code:21207-6306
Practice Address - Country:US
Practice Address - Phone:410-821-9600
Practice Address - Fax:410-821-3790
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03AL1106-A310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD03AL1106-AOtherASSISTED LIVING LICENSE NUMBER