Healthcare Provider Details

I. General information

NPI: 1013824648
Provider Name (Legal Business Name): BISA SHORT-TERM POST- HOSPITALIZATION HOUSING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

#1033, 436 SOUTHBRIDGE STREET SUITE 2
AUBURN MA
01501
US

IV. Provider business mailing address

4005 POSTGATE TERRENCE APT 301
SILVER SPRING MD
20906
US

V. Phone/Fax

Practice location:
  • Phone: 718-810-3412
  • Fax:
Mailing address:
  • Phone: 718-810-3412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320700000X
TaxonomyPhysical Disabilities Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: CHINAECHEREM E ATU
Title or Position: DIRECTOR
Credential:
Phone: 718-810-3412