Healthcare Provider Details

I. General information

NPI: 1346675683
Provider Name (Legal Business Name): MARY ANN AHONE SUBE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2013
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5427 85TH AVE APT 201
LANHAM MD
20706-4515
US

IV. Provider business mailing address

5455 16TH AVE #203
HYATTSVILLE MD
20782
US

V. Phone/Fax

Practice location:
  • Phone: 240-603-2653
  • Fax:
Mailing address:
  • Phone: 301-273-7054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA9443
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: