Provider Demographics
NPI:1639859762
Name:SHEPHERDS SENIOR/DISABLED HOME SOLUTIONS
Entity Type:Organization
Organization Name:SHEPHERDS SENIOR/DISABLED HOME SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:
Authorized Official - First Name:RODNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:VAUGHN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-992-0341
Mailing Address - Street 1:18439 SHANNA DR
Mailing Address - Street 2:
Mailing Address - City:ACCOKEEK
Mailing Address - State:MD
Mailing Address - Zip Code:20607-3209
Mailing Address - Country:US
Mailing Address - Phone:443-992-0341
Mailing Address - Fax:
Practice Address - Street 1:5021 EMO ST
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-2861
Practice Address - Country:US
Practice Address - Phone:202-568-0792
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care