Individual
PRIDE SUH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2611 S CLARK ST, ARLINGTON, VA 22202-4016
(844) 381-4432
Mailing address
3984 WARNER AVE APT D2, LANDOVER HILLS, MD 20784-2010
(240) 487-8673
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
06/22/2022
Last updated
07/13/2023
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