Provider Demographics
NPI:1831586577
Name:REAL CARE AGENCY LLC
Entity type:Organization
Organization Name:REAL CARE AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ MANAGEMENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:CPI, BS, MA, HHA
Authorized Official - Phone:800-722-7164
Mailing Address - Street 1:17120 QUEEN VICTORIA COURT
Mailing Address - Street 2:# 301
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20877
Mailing Address - Country:US
Mailing Address - Phone:800-722-7164
Mailing Address - Fax:877-437-4383
Practice Address - Street 1:4573 LEE RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44128-3757
Practice Address - Country:US
Practice Address - Phone:800-722-7164
Practice Address - Fax:877-437-4383
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2307679305R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization