Provider Demographics
NPI:1447411806
Name:AAA WARMCARE OF POTOMAC, INC
Entity Type:Organization
Organization Name:AAA WARMCARE OF POTOMAC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEVI
Authorized Official - Middle Name:
Authorized Official - Last Name:DATLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-793-6052
Mailing Address - Street 1:10301 GAINSBOROUGH RD
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-4041
Mailing Address - Country:US
Mailing Address - Phone:301-983-6565
Mailing Address - Fax:301-983-0584
Practice Address - Street 1:10301 GAINSBOROUGH RD
Practice Address - Street 2:
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854-4041
Practice Address - Country:US
Practice Address - Phone:301-983-6565
Practice Address - Fax:301-983-0584
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-18
Last Update Date:2008-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15AL080310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility