Organization
HISTORIC HEALTHCARE SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOEBRIAN LEMNYUYTAR (CEO)
(240) 495-8331
Entity
Organization
Contact information
Practice address
1629 K ST NW, WASHINGTON, DC 20006-1602
(301) 332-9778
Mailing address
1629 K ST NW, WASHINGTON, DC 20006-1602
(301) 332-9778
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
—
—
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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