Healthcare Provider Details

I. General information

NPI: 1851642615
Provider Name (Legal Business Name): BRR HOME HEALTH CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2012
Last Update Date: 09/19/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 HAWAII AVE NE
WASHINGTON DC
20011-4927
US

IV. Provider business mailing address

225 HAWAII AVE NE
WASHINGTON DC
20011-4927
US

V. Phone/Fax

Practice location:
  • Phone: 202-500-2564
  • Fax: 202-529-1121
Mailing address:
  • Phone: 202-500-2564
  • Fax: 202-529-1121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RICARDO GRANT SR.
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 202-500-2564