Provider Demographics
NPI:1821475682
Name:MARYLAND CARE OF CAMP SPRINGS LLC
Entity Type:Organization
Organization Name:MARYLAND CARE OF CAMP SPRINGS LLC
Other - Org Name:MARYLAND CARE ADULT MEDICAL DAY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KHANH-LINH
Authorized Official - Middle Name:
Authorized Official - Last Name:FLYNN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-716-3649
Mailing Address - Street 1:4703 OLD SOPER ROAD
Mailing Address - Street 2:SUITE R-1
Mailing Address - City:CAMP SPRINGS
Mailing Address - State:MD
Mailing Address - Zip Code:20746
Mailing Address - Country:US
Mailing Address - Phone:240-716-3649
Mailing Address - Fax:240-427-9999
Practice Address - Street 1:4703 OLD SOPER ROAD
Practice Address - Street 2:SUITE R-1
Practice Address - City:CAMP SPRINGS
Practice Address - State:MD
Practice Address - Zip Code:20746
Practice Address - Country:US
Practice Address - Phone:240-716-3649
Practice Address - Fax:240-716-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-30
Last Update Date:2016-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD261QA0600X
MD16008A261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care