Healthcare Provider Details

I. General information

NPI: 1881411973
Provider Name (Legal Business Name): MANKA'A MARY ASSUMPTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2024
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7101 KURTH LN
LANHAM MD
20706-2169
US

IV. Provider business mailing address

7101 KURTH LN
LANHAM MD
20706-2169
US

V. Phone/Fax

Practice location:
  • Phone: 301-213-0601
  • Fax:
Mailing address:
  • Phone: 301-213-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberHHA200004036
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHHA200004036
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License NumberA00209670
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: