Provider Demographics
NPI:1235490327
Name:CILLA'S ENTERPRISES, LLC
Entity Type:Organization
Organization Name:CILLA'S ENTERPRISES, LLC
Other - Org Name:CARING MATTERS HOME CARE 002
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:CHRISTIANA
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-728-8415
Mailing Address - Street 1:3008 PALADIN TER
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-3005
Mailing Address - Country:US
Mailing Address - Phone:301-728-8415
Mailing Address - Fax:240-342-2127
Practice Address - Street 1:3008 PALADIN TER
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3005
Practice Address - Country:US
Practice Address - Phone:301-728-8415
Practice Address - Fax:240-342-2127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3138251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health