Healthcare Provider Details

I. General information

NPI: 1841386067
Provider Name (Legal Business Name): BERHAN HOME HEALTH CARE AGENCY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 09/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NW SUITE LL 16
WASHINGTON DC
20012-1324
US

IV. Provider business mailing address

7826 EASTERN AVE NW SUITE LL 16
WASHINGTON DC
20012-1324
US

V. Phone/Fax

Practice location:
  • Phone: 202-723-1100
  • Fax: 202-723-3271
Mailing address:
  • Phone: 202-723-1100
  • Fax: 202-723-3271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number097053
License Number StateDC

VIII. Authorized Official

Name: MR. FESSHA WOLDE MOLLALIGN
Title or Position: CEO
Credential:
Phone: 202-723-1100