Healthcare Provider Details

I. General information

NPI: 1902249824
Provider Name (Legal Business Name): JD NURSING AND MANAGEMENT SERVICES INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2013
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9716 SPINNAKER STREET
CHELTENHAM MD
20623-1345
US

IV. Provider business mailing address

9716 SPINNAKER ST
CHELTENHAM MD
20623-1354
US

V. Phone/Fax

Practice location:
  • Phone: 301-281-5657
  • Fax:
Mailing address:
  • Phone: 301-281-5657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code313M00000X
TaxonomyNursing Facility/Intermediate Care Facility
License Number325893409
License Number StateDC

VIII. Authorized Official

Name: MS. DORIS N EZEUDU
Title or Position: HHA
Credential:
Phone: 301-281-5657