Healthcare Provider Details

I. General information

NPI: 1215758735
Provider Name (Legal Business Name): DORIS E ACHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 01/28/2026
Certification Date: 01/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6906 GOOD LUCK RD
LANHAM MD
20706-3707
US

IV. Provider business mailing address

3801 KENILWORTH AVE
BLADENSBURG MD
20710-2122
US

V. Phone/Fax

Practice location:
  • Phone: 240-548-0564
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number200005641
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: