Healthcare Provider Details

I. General information

NPI: 1891292710
Provider Name (Legal Business Name): NEW ERA CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 04/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17 DUVALL LN
GAITHERSBURG MD
20877-1838
US

IV. Provider business mailing address

17 DUVALL LN
GAITHERSBURG MD
20877-1838
US

V. Phone/Fax

Practice location:
  • Phone: 301-956-7996
  • Fax:
Mailing address:
  • Phone: 301-956-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: SAMUEL MENSAH
Title or Position: PRESIDENT
Credential:
Phone: 301-956-7996