Provider Demographics
NPI:1144267147
Name:SIBLEY-SUBURBAN HOME HEALTH AGENCY INC
Entity type:Organization
Organization Name:SIBLEY-SUBURBAN HOME HEALTH AGENCY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VP FINANCE/CFO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:VAN DANIKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-288-8000
Mailing Address - Street 1:6700A ROCKLEDGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20817-2861
Mailing Address - Country:US
Mailing Address - Phone:301-896-6999
Mailing Address - Fax:301-468-3554
Practice Address - Street 1:6700A ROCKLEDGE DR STE 200
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2861
Practice Address - Country:US
Practice Address - Phone:301-896-6999
Practice Address - Fax:301-468-3554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-31
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDHH7084251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024606400Medicaid
MD273263700Medicaid