Provider Demographics
NPI:1972765303
Name:HOMEWATCH CAREGIVERS
Entity type:Organization
Organization Name:HOMEWATCH CAREGIVERS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOSLEY-BETSILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-821-1944
Mailing Address - Street 1:1513 YORK RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5611
Mailing Address - Country:US
Mailing Address - Phone:410-821-1944
Mailing Address - Fax:410-821-1977
Practice Address - Street 1:1513 YORK RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-5611
Practice Address - Country:US
Practice Address - Phone:410-821-1944
Practice Address - Fax:410-821-1977
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-26
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR2539251E00000X
253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD4219031-00Medicaid