Provider Demographics
NPI:1689385783
Name:PEARLDAHLIA, LLC
Entity Type:Organization
Organization Name:PEARLDAHLIA, LLC
Other - Org Name:COMPASSIONATE CAREGIVING AT YOUR DOOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:J
Authorized Official - Last Name:GAINES-ONWUKWE
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:443-655-3262
Mailing Address - Street 1:1013 BEARDS HILL ROAD
Mailing Address - Street 2:SUITE 101-M BOX 268
Mailing Address - City:ABERDEEN
Mailing Address - State:MD
Mailing Address - Zip Code:21001
Mailing Address - Country:US
Mailing Address - Phone:443-655-3262
Mailing Address - Fax:
Practice Address - Street 1:1521 AMERICAN WAY
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:MD
Practice Address - Zip Code:21001-1288
Practice Address - Country:US
Practice Address - Phone:443-655-3262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-12-08
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty