Provider Demographics
NPI:1861015919
Name:UNIQUE CARE OUTREACH
Entity Type:Organization
Organization Name:UNIQUE CARE OUTREACH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MUNONGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-291-1862
Mailing Address - Street 1:3003 ROSALIND AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-6404
Mailing Address - Country:US
Mailing Address - Phone:301-291-1862
Mailing Address - Fax:
Practice Address - Street 1:3003 ROSALIND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-6404
Practice Address - Country:US
Practice Address - Phone:301-291-1862
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-23
Last Update Date:2020-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW20430617OtherW20430617