Provider Demographics
NPI:1245604834
Name:HOMECENTRIS COMMUNITY CARE, LLC
Entity Type:Organization
Organization Name:HOMECENTRIS COMMUNITY CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:TRYBUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-486-5330
Mailing Address - Street 1:10 CROSSROADS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5458
Mailing Address - Country:US
Mailing Address - Phone:410-486-5330
Mailing Address - Fax:410-486-5331
Practice Address - Street 1:3430 ASSOCIATED WAY
Practice Address - Street 2:4TH FLOOR
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21208
Practice Address - Country:US
Practice Address - Phone:410-356-4779
Practice Address - Fax:410-415-1137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-19
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health