Healthcare Provider Details

I. General information

NPI: 1215368832
Provider Name (Legal Business Name): HELENE RELINDIS W. TANTOH TARLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2013
Last Update Date: 03/22/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7826 EASTERN AVE NW STE LL16
WASHINGTON DC
20012-1328
US

IV. Provider business mailing address

7826 EASTERN AVE NW STE LL16
WASHINGTON DC
20012-1328
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 Code374U00000X
TaxonomyHome Health Aide
License NumberHHA9892
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: