Provider Demographics
NPI:1245862234
Name:OAK FARM SOLUTIONS LLC DBA AVILA HOME CARE
Entity type:Organization
Organization Name:OAK FARM SOLUTIONS LLC DBA AVILA HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:OBRIEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-846-0511
Mailing Address - Street 1:1122 KENILWORTH DR STE 217
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2143
Mailing Address - Country:US
Mailing Address - Phone:443-846-0511
Mailing Address - Fax:410-484-7886
Practice Address - Street 1:1122 KENILWORTH DR STE 217
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2143
Practice Address - Country:US
Practice Address - Phone:443-846-0511
Practice Address - Fax:410-484-7886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-07
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR3992ROtherMARYLAND RSA LEVEL 2 LICENSE