Provider Demographics
NPI:1700058906
Name:PASSIONATE HEALTHCARE SERVICES, INC
Entity Type:Organization
Organization Name:PASSIONATE HEALTHCARE SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BEN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:410-660-5925
Mailing Address - Street 1:PO BOX 47224
Mailing Address - Street 2:
Mailing Address - City:WINDSOR MILL
Mailing Address - State:MD
Mailing Address - Zip Code:21244-0224
Mailing Address - Country:US
Mailing Address - Phone:410-660-5925
Mailing Address - Fax:410-298-9234
Practice Address - Street 1:7600 RESERVE CIR
Practice Address - Street 2:SUITE 303
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21244-1605
Practice Address - Country:US
Practice Address - Phone:410-298-9234
Practice Address - Fax:410-298-9234
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2009-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2695R (RSA)251E00000X
MD0707008 NURSINGSTAFF251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD52168022-00OtherMARYLAND DEPARTMENT OF AGING - MDOA