Provider Demographics
NPI:1578156089
Name:SHEPHERD'S CAREONE LLC
Entity Type:Organization
Organization Name:SHEPHERD'S CAREONE LLC
Other - Org Name:SHEPHERD'S HEALTHCARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BOARD CHAIRPERSON/CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TEJUMADE
Authorized Official - Middle Name:ARIKE
Authorized Official - Last Name:FAMAKINWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-344-5819
Mailing Address - Street 1:278 JORDAN DR STE A-9
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-2005
Mailing Address - Country:US
Mailing Address - Phone:302-223-4050
Mailing Address - Fax:
Practice Address - Street 1:278 JORDAN DR STE A-9
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-2005
Practice Address - Country:US
Practice Address - Phone:302-223-4050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-16
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health