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Organization

IMMACULATA SUPPORTS, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PATRICIA AWA (CEO/PROGRAM DIRECTOR)
(443) 226-2711
Entity
Organization

Contact information

Practice address
1629 K ST NW, 300, WASHINGTON, DC 20006-1602
(443) 226-2711
Mailing address
1629 K ST NW, 300, WASHINGTON, DC 20006-1602

Taxonomy

Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
C00005443303
DC

Other

Enumeration date
06/16/2016
Last updated
06/16/2016
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