Provider Demographics
NPI:1770882771
Name:ROSEBUD KADEYAAK
Entity type:Organization
Organization Name:ROSEBUD KADEYAAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANKRAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-210-5577
Mailing Address - Street 1:12605 TROTWOOD COURT
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20704
Mailing Address - Country:US
Mailing Address - Phone:301-210-5577
Mailing Address - Fax:301-210-5577
Practice Address - Street 1:12605 TROTWOOD COURT
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705
Practice Address - Country:US
Practice Address - Phone:301-210-5577
Practice Address - Fax:301-210-5577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROSEBUD KADEYAAK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-17
Last Update Date:2011-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No171R00000XOther Service ProvidersInterpreterGroup - Multi-Specialty
No251E00000XAgenciesHome HealthGroup - Multi-Specialty
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No253Z00000XAgenciesIn Home Supportive Care
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347B00000XTransportation ServicesBusGroup - Multi-Specialty
No347C00000XTransportation ServicesPrivate VehicleGroup - Multi-Specialty
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty