Healthcare Provider Details

I. General information

NPI: 1700149739
Provider Name (Legal Business Name): HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 06/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 BUTTERNUT ST NW
WASHINGTON DC
20012-2423
US

IV. Provider business mailing address

903 BUTTERNUT STREET NW
WASHINGTON DC
20012-2423
US

V. Phone/Fax

Practice location:
  • Phone: 240-938-8740
  • Fax:
Mailing address:
  • Phone: 240-938-8740
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: JEAN FRANCOIS NIKIEMA
Title or Position: HHA
Credential:
Phone: 240-938-8740