Healthcare Provider Details

I. General information

NPI: 1326450289
Provider Name (Legal Business Name): IN HIS NAME JUSTICE, EDUCATION & SOCIAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 05/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1903 BELLE HAVEN DR SUITE 202
LANDOVER MD
20785-4054
US

IV. Provider business mailing address

1903 BELLE HAVEN DR SUITE 202
LANDOVER MD
20785-4054
US

V. Phone/Fax

Practice location:
  • Phone: 240-480-4305
  • Fax:
Mailing address:
  • Phone: 240-480-4305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: MS. CHRISTINE LOIS GALLOWAY
Title or Position: EXEUCTIVE DIRECTOR
Credential:
Phone: 240-480-4305