Organization
EXTENDED CARE &SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DISHANNA HAWKINS (ADMINISTRATOR)
(216) 324-5593
Entity
Organization
Contact information
Practice address
840 BENTLEY DR, PRINCE FREDERICK, MD 20678-3572
(216) 324-5593
Mailing address
840 BENTLEY DR, PRINCE FREDERICK, MD 20678-3572
(216) 324-5593
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
03/25/2025
Last updated
03/25/2025
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