Provider Demographics
NPI:1114776960
Name:SHEKINAH LOVING CARE
Entity type:Organization
Organization Name:SHEKINAH LOVING CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAPHNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KRUAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-205-1284
Mailing Address - Street 1:10111 MARTIN LUTHER KING JR HWY STE 108
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4222
Mailing Address - Country:US
Mailing Address - Phone:240-205-1284
Mailing Address - Fax:301-794-0115
Practice Address - Street 1:10111 MARTIN LUTHER KING JR HWY STE 108
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-4222
Practice Address - Country:US
Practice Address - Phone:240-205-1284
Practice Address - Fax:301-794-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care