Healthcare Provider Details

I. General information

NPI: 1295442077
Provider Name (Legal Business Name): A&A HOMECARE AND MEDICAL PROVISION WITH MEDICAL STAFFING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2022
Last Update Date: 01/09/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N. STREET SW STE 102, 105, 107
WASHINGTON DC
20005
US

IV. Provider business mailing address

7211 PARK HEIGHTS AVE STE 4
PIKESVILLE MD
21208-5497
US

V. Phone/Fax

Practice location:
  • Phone: 301-408-8763
  • Fax:
Mailing address:
  • Phone: 301-640-8687
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: GISSELLA MANA
Title or Position: ALT. DIRECTOR/SERVICE COORDINATOR
Credential:
Phone: 301-640-8687