Healthcare Provider Details
I. General information
NPI: 1780400804
Provider Name (Legal Business Name): ORA HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/25/2024
Last Update Date: 11/25/2024
Certification Date: 11/24/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2522B VIRGINIA AVE NW
WASHINGTON DC
20037-1904
US
IV. Provider business mailing address
2522B VIRGINIA AVE NW
WASHINGTON DC
20037-1904
US
V. Phone/Fax
- Phone: 202-878-9161
- Fax:
- Phone: 202-878-9161
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0850X |
| Taxonomy | Adult Mental Health Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QM0855X |
| Taxonomy | Adolescent and Children Mental Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
HAMZA
WARDERE
Title or Position: CEO
Credential:
Phone: 703-623-4515