Organization
DESIRE HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COURAGE NTUMLA KWI-MANCHO (OWNER)
(240) 505-9321
Entity
Organization
Contact information
Practice address
9500 ANNAPOLIS RD STE B5, LANHAM, MD 20706-2078
(301) 494-4060
(301) 494-6667
Mailing address
9701 APOLLO DR STE 100, LARGO, MD 20774-4785
(301) 494-4060
(301) 494-6667
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115459
MEDICARE
MD
Enumeration date
02/01/2021
Last updated
01/07/2022
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