NPI 1366165789

Old Home Place INC

Organisation Adult Care Home Facility Fruitland, MD

Practice location

Address: 406 Ogle Avenue, Fruitland, MD 21826
Phone: (443) 454-1507
Fax: (443) 859-8953

Authorised official

Name: Louston Labrante Fountain
Title: Ceo
Phone: (443) 454-1507

Registered specialties

Adult Care Home Facility Primary

Nursing & Custodial Care Facilities Taxonomy 311ZA0620X

Other Custodial Care Facility providers in Maryland →

Registry record

NPI: 1366165789
Entity type: Organization
NPI issued: 21 Sep 2022
Record last updated: 21 Sep 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.