Organization
HOME HEALTH AID
Active
Other names
home health
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IZIMEKWA I ONDEPE III M (M)
(240) 467-1546
Entity
Organization
Contact information
Practice address
5822 MENTANA ST, 5, NEW CARROLLTON, MD 20784-3505
(240) 467-1546
Mailing address
5822 MENTANA ST, NEW CARROLLTON, MD 20784-3505
(240) 467-1546
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
HHA12447
DC
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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