Healthcare Provider Details

I. General information

NPI: 1497397962
Provider Name (Legal Business Name): SENIOR HOMECARE SERVICE & STAFFING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2019
Last Update Date: 04/04/2024
Certification Date: 04/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1818 NEW YORK AVE NE STE 219
WASHINGTON DC
20002-1851
US

IV. Provider business mailing address

1818 NEW YORK AVE NE STE 219
WASHINGTON DC
20002-1851
US

V. Phone/Fax

Practice location:
  • Phone: 202-269-0008
  • Fax: 202-269-0866
Mailing address:
  • Phone: 202-269-0008
  • Fax: 202-269-0866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. MOHAMED SHARIF
Title or Position: PRESIDENT/CEO
Credential:
Phone: 202-556-7054