Organization
EBENEZER ETTA HEALTHCARE SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESTELLA ETTA (OWNER)
(240) 260-8882
Entity
Organization
Contact information
Practice address
4200 FORBES BLVD STE 1094200, LANHAM, MD 20706-4342
(240) 353-6067
(667) 290-6344
Mailing address
4200 FORBES BLVD STE 1094200, LANHAM, MD 20706-4342
(240) 260-8882
(667) 290-6344
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
—
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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