Provider Demographics
| NPI: | 1649756735 |
|---|---|
| Name: | AMAZING CARE HEALTH SERVICES LLC |
| Entity type: | Organization |
| Organization Name: | AMAZING CARE HEALTH SERVICES LLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO/OWNER |
| Authorized Official - Prefix: | DR |
| Authorized Official - First Name: | STELLA |
| Authorized Official - Middle Name: | OA |
| Authorized Official - Last Name: | EPEY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | DOCTOR IN DIVINITY |
| Authorized Official - Phone: | 423-208-0179 |
| Mailing Address - Street 1: | 6314 WINDSOR MILL RD |
| Mailing Address - Street 2: | SUITE 201B |
| Mailing Address - City: | GWYNN OAK |
| Mailing Address - State: | MD |
| Mailing Address - Zip Code: | 21207 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 410-265-0023 |
| Mailing Address - Fax: | 410-265-0027 |
| Practice Address - Street 1: | 6314 WINDSOR MILL RD STE 201B |
| Practice Address - Street 2: | |
| Practice Address - City: | GWYNN OAK |
| Practice Address - State: | MD |
| Practice Address - Zip Code: | 21207-6095 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 423-208-0179 |
| Practice Address - Fax: | 410-265-0027 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2018-07-12 |
| Last Update Date: | 2021-06-09 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| MD | R4248 | 251J00000X |
| 251S00000X, 261QD1600X, 261QH0100X, 261QM0801X, 261QM0855X, 261QR0401X, 261QR0405X, 3140N1450X, 320800000X, 320900000X, 323P00000X, 3245S0500X, 385H00000X, 251E00000X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization |
|---|---|---|---|---|
| Yes | 251E00000X | Agencies | Home Health | |
| No | 251J00000X | Agencies | Nursing Care | |
| No | 251S00000X | Agencies | Community/Behavioral Health | |
| No | 261QD1600X | Ambulatory Health Care Facilities | Clinic/Center | Developmental Disabilities |
| No | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center | Health Service |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) |
| No | 261QM0855X | Ambulatory Health Care Facilities | Clinic/Center | Adolescent and Children Mental Health |
| No | 261QR0401X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
| No | 3140N1450X | Nursing & Custodial Care Facilities | Skilled Nursing Facility | Nursing Care, Pediatric |
| No | 320800000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Mental Illness | |
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| No | 323P00000X | Residential Treatment Facilities | Psychiatric Residential Treatment Facility | |
| No | 3245S0500X | Residential Treatment Facilities | Substance Abuse Rehabilitation Facility | Substance Abuse Treatment, Children |
| No | 385H00000X | Respite Care Facility | Respite Care |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MD | 139290500 | Medicaid | |
| MD | R4284 | Other | OFFICE OF HEALTH ACRE QUALITY (OHCQ) |
| MD | 5139290500 | Medicaid |
