Healthcare Provider Details

I. General information

NPI: 1508095027
Provider Name (Legal Business Name): VIZION ONE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/06/2009
Last Update Date: 07/06/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 GALLATIN ST NE
WASHINGTON DC
20017-2856
US

IV. Provider business mailing address

1237 GALLATIN ST NE
WASHINGTON DC
20017-2856
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-0211
  • Fax:
Mailing address:
  • Phone: 202-545-0211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNSA-0125
License Number StateDC

VIII. Authorized Official

Name: ABDALLAH KITWARA
Title or Position: CEO
Credential: MBA
Phone: 202-545-0211