Provider Demographics
NPI:1255006136
Name:TMDEEDLLC
Entity Type:Organization
Organization Name:TMDEEDLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MONROKE
Authorized Official - Middle Name:OLUBUKOLA
Authorized Official - Last Name:EKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-805-9715
Mailing Address - Street 1:4815 OLD COURT RD
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4626
Mailing Address - Country:US
Mailing Address - Phone:410-805-9715
Mailing Address - Fax:
Practice Address - Street 1:4815 OLD COURT RD
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4626
Practice Address - Country:US
Practice Address - Phone:410-805-9715
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances