Provider Demographics
NPI:1942064845
Name:E & E ADULT DAY CARE CENTER LLC
Entity Type:Organization
Organization Name:E & E ADULT DAY CARE CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:EMMERENCIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MORDI
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:240-354-4069
Mailing Address - Street 1:12802 DOMINICS BEQUEST CT
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-5623
Mailing Address - Country:US
Mailing Address - Phone:240-354-4069
Mailing Address - Fax:
Practice Address - Street 1:12802 DOMINICS BEQUEST CT
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-5623
Practice Address - Country:US
Practice Address - Phone:240-354-4069
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities