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Organization

PHOENIX HOME CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KISH BOLDEN (DIRECTOR)
(609) 705-2561
Entity
Organization

Contact information

Practice address
12334 QUARTERBACK CT, BOWIE, MD 20720-4396
(609) 705-2561
Mailing address
12334 QUARTERBACK CT, BOWIE, MD 20720-4396
(609) 705-2561

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
251J00000X
Nursing Care Agency

Other

Enumeration date
01/15/2025
Last updated
02/03/2025
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