Provider Demographics
NPI:1598428054
Name:AMAZING LOVE RESIDENTIAL CARE CORPORATION
Entity Type:Organization
Organization Name:AMAZING LOVE RESIDENTIAL CARE CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:WAZIRI
Authorized Official - Middle Name:
Authorized Official - Last Name:IBRAHIM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-237-6373
Mailing Address - Street 1:6215 GREENBELT RD STE 303
Mailing Address - Street 2:
Mailing Address - City:BERWYN HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20740-2363
Mailing Address - Country:US
Mailing Address - Phone:301-237-6373
Mailing Address - Fax:
Practice Address - Street 1:6215 GREENBELT RD STE 303
Practice Address - Street 2:
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2363
Practice Address - Country:US
Practice Address - Phone:301-237-6373
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health