Provider Demographics
NPI:1013306349
Name:COLUMBIA SENIOR HOME CARE LLC
Entity type:Organization
Organization Name:COLUMBIA SENIOR HOME CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLAHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-290-0171
Mailing Address - Street 1:6030 MARSHALEE DR
Mailing Address - Street 2:SUITE M260
Mailing Address - City:ELKRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21075-5987
Mailing Address - Country:US
Mailing Address - Phone:410-290-0171
Mailing Address - Fax:443-583-0735
Practice Address - Street 1:6232 BROKEN WING CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-7403
Practice Address - Country:US
Practice Address - Phone:410-290-0171
Practice Address - Fax:443-583-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-09
Last Update Date:2015-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health