Provider Demographics
NPI:1326734336
Name:ENDEARMENT ASSISTED LIVING
Entity Type:Organization
Organization Name:ENDEARMENT ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LABAKE
Authorized Official - Middle Name:GUMAKE
Authorized Official - Last Name:OGUNNUPE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-276-9353
Mailing Address - Street 1:547 RIVERSIDE DR STE A
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21801-5369
Mailing Address - Country:US
Mailing Address - Phone:202-276-9353
Mailing Address - Fax:
Practice Address - Street 1:107 WALNUT LN
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-5001
Practice Address - Country:US
Practice Address - Phone:202-276-9353
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility