- Enrollment id
- O20071210000268
- Enrollment state
- MD
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1144400805
- Multiple npi flag
- N
- Ccn
- 217107
- Associate id
- 3678662921
- Organization name
- HOMECARE MARYLAND, LLC
- Doing business as name
- HOMECARE MARYLAND
- Incorporation date
- 2007-10-26
- Incorporation state
- MD
- Organization type structure
- LLC
- Proprietary nonprofit
- P
- Address line 1
- 10090 RED RUN BLVD
- Address line 2
- FL 3
- City
- OWINGS MILLS
- State
- MD
- Zip code
- 211174827