Organization
EVISION MEDICAL ADULT DAY CENTER CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHALITA SMITH (OWNER)
(443) 739-2084
Entity
Organization
Contact information
Practice address
100 S. TAYLOR AVE, ESSEX, MD 21221
(443) 739-2084
Mailing address
4806 MANTLEWOOD WAY APT 102, ABERDEEN, MD 21001-3646
(443) 739-2084
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2188G72M
MEDICARE, MEDICAID, MEDICAL ASSISTANCE, PRIVATE PAYER
MD
Enumeration date
09/16/2021
Last updated
09/29/2021
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