Provider Demographics
NPI:1770131302
Name:MAE WEBB CARE, LLC
Entity type:Organization
Organization Name:MAE WEBB CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:TAHIRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:GOLDSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-965-0521
Mailing Address - Street 1:14300 GALLANT FOX LN STE 211
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4033
Mailing Address - Country:US
Mailing Address - Phone:301-965-0251
Mailing Address - Fax:
Practice Address - Street 1:14300 GALLANT FOX LN STE 211
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4033
Practice Address - Country:US
Practice Address - Phone:301-965-0251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-27
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health