Provider Demographics
NPI:1376327858
Name:COTH CARE LLC
Entity Type:Organization
Organization Name:COTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:AMUSA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-418-6387
Mailing Address - Street 1:1821 N SMALLWOOD ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21216-3724
Mailing Address - Country:US
Mailing Address - Phone:410-225-7888
Mailing Address - Fax:410-225-0033
Practice Address - Street 1:1821 N SMALLWOOD ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21216-3724
Practice Address - Country:US
Practice Address - Phone:410-225-7888
Practice Address - Fax:410-225-0033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care