Organization
C AND C LOVING HEART HEALTH CARE AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTIE SIMON-WATERMAN CRNP (OWNER/ADMINISTRATOR)
(443) 867-7471
Entity
Organization
Contact information
Practice address
5122 CREST HAVEN WAY, PERRY HALL, MD 21128
(410) 256-5710
(410) 256-6052
Mailing address
5122 CREST HAVEN WAY, PERRY HALL, MD 21128-9793
(410) 256-5710
(410) 256-6052
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
251E00000X
Home Health Agency
—
—
251J00000X
Nursing Care Agency
Primary
R158240
MD
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
06/27/2018
Last updated
06/09/2021
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