Organization
IMMACULATE HEALTH CARE SERVICES,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH .A. OSUJI (ADMINISTRATOR)
(202) 832-8340
Entity
Organization
Contact information
Practice address
12817 ODENS BEQUEST DR, BOWIE, MD 20720
(202) 832-8340
(202) 832-8341
Mailing address
1818 NEW YORK AVE NE, SUITE 228, WASHINGTON, DC 20002-1848
(202) 832-8340
(202) 832-8341
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HCA0012
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
035810300
—
DC
Enumeration date
02/13/2009
Last updated
02/13/2009
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