Provider Demographics
NPI:1447872775
Name:DELUXE HOME HEALTHCARE SERVICES
Entity type:Organization
Organization Name:DELUXE HOME HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FATMATA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMARA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-802-8450
Mailing Address - Street 1:3354 CRUMPTON S
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-2200
Mailing Address - Country:US
Mailing Address - Phone:301-802-8450
Mailing Address - Fax:
Practice Address - Street 1:3354 CRUMPTON S
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-2200
Practice Address - Country:US
Practice Address - Phone:301-802-8450
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD560244757072Medicaid