Provider Demographics
NPI:1144632811
Name:APEX CARE RESIDENTIAL SERVICES LLC
Entity type:Organization
Organization Name:APEX CARE RESIDENTIAL SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:VALENTINE
Authorized Official - Middle Name:AMAH
Authorized Official - Last Name:BAMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-415-4149
Mailing Address - Street 1:6011 EMERSON ST APT 405
Mailing Address - Street 2:
Mailing Address - City:BLADENSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20710-1836
Mailing Address - Country:US
Mailing Address - Phone:443-415-4149
Mailing Address - Fax:
Practice Address - Street 1:120 CHLOE ST
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3591
Practice Address - Country:US
Practice Address - Phone:443-415-4149
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health