Provider Demographics
NPI:1164002093
Name:ACCESS CARE ASSISTED LIVING, LLC
Entity type:Organization
Organization Name:ACCESS CARE ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTED LIVING MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LORETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:OKEKE
Authorized Official - Suffix:
Authorized Official - Credentials:CMT
Authorized Official - Phone:240-461-3162
Mailing Address - Street 1:13100 BAR GEESE CT
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-7012
Mailing Address - Country:US
Mailing Address - Phone:301-464-4303
Mailing Address - Fax:301-390-7083
Practice Address - Street 1:3903 CLAXTON PL
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-1340
Practice Address - Country:US
Practice Address - Phone:301-464-4303
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-04-13
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0630XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Behavioral Disturbances