Provider Demographics
NPI:1245778414
Name:MILITARY CAREGIVERS OF AMERICA, LLC
Entity Type:Organization
Organization Name:MILITARY CAREGIVERS OF AMERICA, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & MANAGING DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ELOISE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-574-8100
Mailing Address - Street 1:15510 HUMBERSIDE WAY
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-8046
Mailing Address - Country:US
Mailing Address - Phone:301-574-8100
Mailing Address - Fax:
Practice Address - Street 1:15510 HUMBERSIDE WAY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8046
Practice Address - Country:US
Practice Address - Phone:301-574-8100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-07
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNRSA140013251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health