Provider Demographics
NPI:1679772925
Name:DEPENDABLE RELIABLE SERVICE
Entity Type:Organization
Organization Name:DEPENDABLE RELIABLE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTORE
Authorized Official - Prefix:MISS
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-296-3751
Mailing Address - Street 1:1300 MERCANTILE LN
Mailing Address - Street 2:158
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5327
Mailing Address - Country:US
Mailing Address - Phone:240-296-3751
Mailing Address - Fax:240-296-3754
Practice Address - Street 1:1300 MERCANTILE LN
Practice Address - Street 2:158
Practice Address - City:LARGO
Practice Address - State:MD
Practice Address - Zip Code:20774-5327
Practice Address - Country:US
Practice Address - Phone:240-296-3751
Practice Address - Fax:240-296-3754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD0409002251E00000X
MDR2258251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health