Provider Demographics
NPI:1093514523
Name:PERIDOT CARE SERVICES LTD.
Entity type:Organization
Organization Name:PERIDOT CARE SERVICES LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:KAFAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:AGABA
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:302-242-9622
Mailing Address - Street 1:79 SEACROFT DR
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-3804
Mailing Address - Country:US
Mailing Address - Phone:302-242-9622
Mailing Address - Fax:
Practice Address - Street 1:79 SEACROFT DR
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-3804
Practice Address - Country:US
Practice Address - Phone:302-242-9622
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health