Provider Demographics
NPI:1659779197
Name:STAY HOME SENIOR SERVICES OF MARYLAND, INC.
Entity Type:Organization
Organization Name:STAY HOME SENIOR SERVICES OF MARYLAND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LOUANN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-739-2273
Mailing Address - Street 1:16731 LONGSTREET DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-1414
Mailing Address - Country:US
Mailing Address - Phone:017-392-2733
Mailing Address - Fax:301-733-9663
Practice Address - Street 1:16731 LONGSTREET DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-1414
Practice Address - Country:US
Practice Address - Phone:301-739-2273
Practice Address - Fax:301-733-9663
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-16
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD090702253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1659779197Medicaid