Provider Demographics
NPI:1891244042
Name:A NETWORK OF CARE HOME HEALTHCARE SPECIALISTS, LLC
Entity Type:Organization
Organization Name:A NETWORK OF CARE HOME HEALTHCARE SPECIALISTS, LLC
Other - Org Name:A NETWORK OF CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-379-4555
Mailing Address - Street 1:11350 PEMBROOKE SQ STE 313
Mailing Address - Street 2:
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20603-4809
Mailing Address - Country:US
Mailing Address - Phone:301-885-2100
Mailing Address - Fax:866-449-4111
Practice Address - Street 1:11350 PEMBROOKE SQ STE 313
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4809
Practice Address - Country:US
Practice Address - Phone:301-885-2100
Practice Address - Fax:866-449-4111
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-29
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2301253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care