Healthcare Provider Details

I. General information

NPI: 1770490583
Provider Name (Legal Business Name): A4 GROUP, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11425 RAMBLING RD
GAITHERSBURG MD
20879-3415
US

IV. Provider business mailing address

11425 RAMBLING RD
GAITHERSBURG MD
20879-3415
US

V. Phone/Fax

Practice location:
  • Phone: 301-728-5200
  • Fax:
Mailing address:
  • Phone: 301-728-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name: MS. SHANAJ M. TARIQUL PERVIN
Title or Position: PRESIDENT
Credential:
Phone: 301-728-5200