Organization
CITADEL HOME HEALTHCARE LIMITED LIABILITY COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIDNEY MALCOLM WATERS CNA (CEO)
(443) 929-0406
Entity
Organization
Contact information
Practice address
2111 SUNBRIAR LN UNIT B, GWYNN OAK, MD 21207-5987
(443) 929-0406
(443) 308-0793
Mailing address
2111 SUNBRIAR LN UNIT B, GWYNN OAK, MD 21207-5987
(443) 929-0406
(443) 308-0793
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
253Z00000X
In Home Supportive Care Agency
—
—
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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