Provider Demographics
NPI:1750504320
Name:JUEL'S ADULT DAY CARE, INC.
Entity Type:Organization
Organization Name:JUEL'S ADULT DAY CARE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-367-8802
Mailing Address - Street 1:3401 EDGEWOOD RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-7320
Mailing Address - Country:US
Mailing Address - Phone:410-367-8802
Mailing Address - Fax:410-367-9752
Practice Address - Street 1:100 WEST RD
Practice Address - Street 2:SUITE 358
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2331
Practice Address - Country:US
Practice Address - Phone:410-494-1906
Practice Address - Fax:410-494-1945
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12788314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD817772400Medicaid