| NPI | 1306302435 |
|---|---|
| Former Legal Business Name | AGELESS HEALTHCARE LLC |
| Entity Type | Organization |
| Authorized Contact | CARLENE GAYLE GAYLE BANKS Administrator 240-481-7844 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3140N1450X Skilled Nursing Facility Nursing Care, Pediatric |
| Additional Taxonomies | 251E00000X Home Health |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2020-12-11 |