Healthcare Provider Details

I. General information

NPI: 1881396141
Provider Name (Legal Business Name): E&J CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 N ST NW
WASHINGTON DC
20005-2843
US

IV. Provider business mailing address

1420 N ST NW
WASHINGTON DC
20005-2843
US

V. Phone/Fax

Practice location:
  • Phone: 302-897-6066
  • Fax:
Mailing address:
  • Phone: 202-977-7010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: JERATE NGWASHI MUNGU
Title or Position: CEO
Credential:
Phone: 302-897-6066