1336262765 NPI number — WE CARE ADULT SERVICES, INC.

Table of content: (NPI 1336262765)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336262765 NPI number — WE CARE ADULT SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WE CARE ADULT SERVICES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1336262765
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4642
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAPITOL HEIGHTS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20791-4642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-925-1515
Provider Business Mailing Address Fax Number:
301-925-1674

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1717 LARGO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
UPPER MARLBORO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20774-8524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-925-1515
Provider Business Practice Location Address Fax Number:
301-925-1674
Provider Enumeration Date:
04/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
DOUGLAS
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
CHARLES
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
301-925-1515

Provider Taxonomy Codes

  • Taxonomy code: 261QA0600X , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 026461300 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 558900200 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com