Provider Demographics
NPI:1063729283
Name:AYNJEL HEALTHCARE
Entity type:Organization
Organization Name:AYNJEL HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRISTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-402-0944
Mailing Address - Street 1:612 TINKER RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21220-3799
Mailing Address - Country:US
Mailing Address - Phone:410-391-3707
Mailing Address - Fax:
Practice Address - Street 1:612 TINKER RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21220-3799
Practice Address - Country:US
Practice Address - Phone:410-391-3707
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-09
Last Update Date:2010-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR128308251B00000X, 251F00000X, 251J00000X, 251S00000X, 251T00000X, 251V00000X, 253Z00000X, 251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251B00000XAgenciesCase Management
No251F00000XAgenciesHome Infusion
No251J00000XAgenciesNursing Care
No251S00000XAgenciesCommunity/Behavioral Health
No251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No251V00000XAgenciesVoluntary or Charitable
No253Z00000XAgenciesIn Home Supportive Care