Healthcare Provider Details

I. General information

NPI: 1730007345
Provider Name (Legal Business Name): SHAMAH CARE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2026
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6109 ROSEDALE DR
HYATTSVILLE MD
20782-2296
US

IV. Provider business mailing address

6109 ROSEDALE DR
HYATTSVILLE MD
20782-2296
US

V. Phone/Fax

Practice location:
  • Phone: 202-718-8942
  • Fax:
Mailing address:
  • Phone: 202-718-8942
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: JUSTINE ASAHA
Title or Position: CEO
Credential: MSC
Phone: 202-718-8942