Provider Demographics
NPI:1053935676
Name:GOOD CARE PROVIDERS LLC
Entity type:Organization
Organization Name:GOOD CARE PROVIDERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:OMONIIGHO
Authorized Official - Middle Name:
Authorized Official - Last Name:ABEDUO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-447-8739
Mailing Address - Street 1:6016 NAHANT RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21206-3133
Mailing Address - Country:US
Mailing Address - Phone:443-447-8739
Mailing Address - Fax:
Practice Address - Street 1:6016 NAHANT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21206-3133
Practice Address - Country:US
Practice Address - Phone:443-447-8739
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-29
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care