Provider Demographics
NPI:1568620771
Name:D & J PERSONAL CARE SERVICES
Entity Type:Organization
Organization Name:D & J PERSONAL CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:BREAKFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-905-7977
Mailing Address - Street 1:1011 REVERDY RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21212-3224
Mailing Address - Country:US
Mailing Address - Phone:410-905-7977
Mailing Address - Fax:410-510-1648
Practice Address - Street 1:1011 REVERDY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21212-3224
Practice Address - Country:US
Practice Address - Phone:410-905-7977
Practice Address - Fax:410-510-1648
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:D & J PROPERTY MANAGEMENT, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-05-26
Last Update Date:2008-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9205021-00251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health