Active NPI
Waves of Life Home Care Group Inc
- Addiction Medicine (Family Medicine) Physician
- Baltimore, MD
National Provider Identifier
1821808478
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Family Medicine) Physician
- Legal business name
- WAVES OF LIFE HOME CARE GROUP INC
- Practice address
- 1340 Smith Ave
Baltimore, MD 21209-3701 - Phone
- (443) 894-8646
- NPI assigned
- Jan 7, 2025
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Temple Debrocka Parker
- Title
- Ceo
- Phone
- (443) 894-8646
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Family Medicine) Physician | 207QA0401X | Primary |
Addresses
Primary practice location
1340 Smith Ave
Baltimore, MD 21209-3701
Mailing address
1340 Smith Ave
Baltimore, MD 21209-3701
Phone (443) 894-8646
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736208000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736208000000",
"number": "1821808478",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1340 SMITH AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093701",
"telephone_number": "443-894-8646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1340 SMITH AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212093701",
"telephone_number": "443-894-8646"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "WAVES OF LIFE HOME CARE GROUP INC",
"organizational_subpart": "NO",
"enumeration_date": "2025-01-07",
"last_updated": "2025-01-07",
"certification_date": "2025-01-07",
"status": "A",
"authorized_official_last_name": "PARKER",
"authorized_official_first_name": "TEMPLE",
"authorized_official_middle_name": "DEBROCKA",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "443-894-8646",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207QA0401X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine, Addiction Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.