Organization
LIFESPAN HOME WELLNESS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AISHA ABDUL-SAMAD (MS, CCC-SLP)
(443) 306-9406
Entity
Organization
Contact information
Practice address
5615 ASHBURN TER, FREDERICK, MD 21703-9491
(555) 555-5555
Mailing address
5615 ASHBURN TER, FREDERICK, MD 21703-9491
(443) 306-9406
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
05356
MD
Other
Enumeration date
06/28/2016
Last updated
06/28/2016
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