Provider Demographics
NPI:1932074291
Name:PRIME NURTURING HOME CARE LLC
Entity type:Organization
Organization Name:PRIME NURTURING HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:ADDY
Authorized Official - Suffix:
Authorized Official - Credentials:NURSE
Authorized Official - Phone:347-759-3606
Mailing Address - Street 1:1727 MILL BRANCH DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708
Mailing Address - Country:US
Mailing Address - Phone:347-759-3606
Mailing Address - Fax:
Practice Address - Street 1:1727 MILL BRANCH DRIVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708
Practice Address - Country:US
Practice Address - Phone:347-759-3606
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care ProviderGroup - Multi-Specialty