Healthcare Provider Details

I. General information

NPI: 1982576609
Provider Name (Legal Business Name): WILLER AUGUSTIN HHA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/22/2025
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 24TH ST NE
WASHINGTON DC
20018-2126
US

IV. Provider business mailing address

203 16TH ST NE APT 3
WASHINGTON DC
20002-6542
US

V. Phone/Fax

Practice location:
  • Phone: 202-832-8340
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200005290
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: