NPIMap

Organization Active NPI

Our Family Tree

  • In Home Supportive Care Agency
  • Baltimore, MD
National Provider Identifier
1972861193
Registry record updated Apr 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
License
R3139 Issued in MD
Legal business name
OUR FAMILY TREE
Doing business as
Caring Matters Home Care
Practice address
1203 Lakeside Ave
Baltimore, MD 21218-3002
Phone
(443) 608-0401
Fax
(410) 243-2246
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2012

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

Authorized official

Name
Mr. Antonio Daniel Distance
Title
President / C.E.O
Phone
(443) 608-0401

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X R3139 MD Primary

Addresses

Primary practice location

1203 Lakeside Ave
Baltimore, MD 21218-3002

Mailing address

1203 Lakeside Ave
Baltimore, MD 21218
Phone (443) 608-0401

Other names 1

  • Caring Matters Home Care Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1972861193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 LAKESIDE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "443-608-0401",
            "fax_number": "410-243-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 LAKESIDE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212183002",
            "telephone_number": "443-608-0401",
            "fax_number": "410-243-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OUR FAMILY TREE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "DISTANCE",
        "authorized_official_first_name": "ANTONIO",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT / C.E.O",
        "authorized_official_telephone_number": "443-608-0401",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "MD",
            "license": "R3139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Caring Matters Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 25, 2012; 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.