Provider Demographics
NPI:1831680958
Name:BESTCARE HOME INC
Entity type:Organization
Organization Name:BESTCARE HOME INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SOUNG
Authorized Official - Middle Name:H
Authorized Official - Last Name:PARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-677-2039
Mailing Address - Street 1:10617 DUTHESS WAY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:MD
Mailing Address - Zip Code:21163
Mailing Address - Country:US
Mailing Address - Phone:443-677-2039
Mailing Address - Fax:410-465-3891
Practice Address - Street 1:10617 DUTHESS WAY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:MD
Practice Address - Zip Code:21163
Practice Address - Country:US
Practice Address - Phone:443-677-2039
Practice Address - Fax:410-465-3891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR4174253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD45-4992152Medicaid
MDR4174Medicaid