Provider Demographics
NPI:1801186978
Name:PERPETUAL HOME HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:PERPETUAL HOME HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF NURSING/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:B
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-434-0015
Mailing Address - Street 1:9725 HEDIN DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1805
Mailing Address - Country:US
Mailing Address - Phone:301-434-0015
Mailing Address - Fax:301-439-4812
Practice Address - Street 1:9725 HEDIN DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20903-1805
Practice Address - Country:US
Practice Address - Phone:301-434-0015
Practice Address - Fax:301-439-4812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-11
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR-180924163WA2000X
MDR2883251E00000X
MD300906800385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No163WA2000XNursing Service ProvidersRegistered NurseAdministratorGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5300905000Medicaid
MD5300906800Medicaid