Provider Demographics
NPI:1558797985
Name:ATLAS CARE CONNECT
Entity type:Organization
Organization Name:ATLAS CARE CONNECT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NKECHINYERE
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-377-8511
Mailing Address - Street 1:4025 EASTERN AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-4226
Mailing Address - Country:US
Mailing Address - Phone:301-220-0436
Mailing Address - Fax:301-220-1751
Practice Address - Street 1:4025 EASTERN AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21224-4226
Practice Address - Country:US
Practice Address - Phone:301-220-0436
Practice Address - Fax:301-220-1751
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ATLAS HOME HEALTH CONSULTING, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-17
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD130803253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD130803OtherDHMH
MD1309031OtherDHMH