Provider Demographics
NPI:1578094249
Name:SHEPHERD'S STAFF IN-HOME CARE L.L.C.
Entity Type:Organization
Organization Name:SHEPHERD'S STAFF IN-HOME CARE L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:AMELIA
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-304-9143
Mailing Address - Street 1:205 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-6501
Mailing Address - Country:US
Mailing Address - Phone:301-304-9143
Mailing Address - Fax:
Practice Address - Street 1:205 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6501
Practice Address - Country:US
Practice Address - Phone:301-304-9143
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-24
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR3661253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care