Organization
KELLY-WISE, LLC
Active
Other names
Right at Home
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHEILA D WISE (ADMINISTRATOR)
(301) 645-0040
Entity
Organization
Contact information
Practice address
3680 LEONARDTOWN RD, SUITE 202, WALDORF, MD 20601-3696
(301) 645-0040
(301) 645-0880
Mailing address
3680 LEONARDTOWN RD, SUITE 202, WALDORF, MD 20601-3696
(301) 645-0040
(301) 645-0880
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
R2720
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0163430306
—
VA
05
—
2626047-00
—
MD
Enumeration date
04/11/2010
Last updated
11/21/2011
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