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Organization
OLD HOME PLACE INC
Active
Organization
OLD HOME PLACE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LOUSTON LABRANTE FOUNTAIN (CEO)
(443) 454-1507
Entity
Organization
Contact information
Practice address
406 OGLE AVENUE, FRUITLAND, MD 21826
(443) 454-1507
(443) 859-8953
Mailing address
406 OGLE AVENUE, FRUITLAND, MD 21826
(443) 454-1507
(443) 859-8953
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
—
—
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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