1487113239 NPI number — HOMECENTRIS HOME HEALTH II, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487113239 NPI number — HOMECENTRIS HOME HEALTH II, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HOMECENTRIS HOME HEALTH II, LLC
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:
6
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:
1487113239
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 CROSSROADS DR STE 102
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OWINGS MILLS
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21117-5459
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-486-5330
Provider Business Mailing Address Fax Number:
410-486-8331

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 CROSSROADS DR STE 102
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OWINGS MILLS
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21117-5459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-321-8448
Provider Business Practice Location Address Fax Number:
410-494-4918
Provider Enumeration Date:
03/19/2019

Additional Information

Authorized Official

Authorized Official Last Name:
AUMAN
Authorized Official First Name:
MATTHEW
Authorized Official Middle Name:
FRANCIS
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
410-486-5330

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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