Organization Active NPI

Waves of Life Home Care Group Inc

  • Addiction Medicine (Family Medicine) Physician
  • Baltimore, MD
National Provider Identifier
1821808478
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
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

Updated by the provider on Jan 7, 2025

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)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 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 Directory

NPI 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.

Verify at the official NPI Registry.