Citadel Home Healthcare Limited Liability Company

Primary specialty

Home Health Registered NurseTaxonomy code 163WH0200X

Legal business name

CITADEL HOME HEALTHCARE LIMITED LIABILITY COMPANY

Practice address

2111 Sunbriar LN Unit B
Gwynn Oak, MD 21207-5987

Phone

(443) 929-0406

Fax

(443) 308-0793

NPI assigned

Aug 25, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Sidney Malcolm Waters, CNANPI 1164123790

Title

Ceo

Phone

(443) 929-0406

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Sidney M Waters

  • Home Health Aide
  • Baltimore, MD
  • NPI 1164123790
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692921600000",
    "number": "1821873209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 SUNBRIAR LN UNIT B",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075987",
            "telephone_number": "443-929-0406",
            "fax_number": "443-308-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 SUNBRIAR LN UNIT B",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212075987",
            "telephone_number": "443-929-0406",
            "fax_number": "443-308-0793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITADEL HOME HEALTHCARE LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-25",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A",
        "authorized_official_last_name": "WATERS",
        "authorized_official_first_name": "SIDNEY",
        "authorized_official_middle_name": "MALCOLM",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-929-0406",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CNA"
    },
    "taxonomies": [
        {
            "code": "163WH0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Home Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Home Health Registered Nurse in Gwynn Oak, MD
• Providers in Gwynn Oak, MD by specialty
• Home Health Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2023; 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.