Healthcare Provider Details

I. General information

NPI: 1639833676
Provider Name (Legal Business Name): NEW DAWN HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 07/30/2024
Certification Date: 01/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14502 GREENVIEW DR STE 400L14
LAUREL MD
20708-3287
US

IV. Provider business mailing address

12816 MARLTON CENTER DR
UPPER MARLBORO MD
20772-5150
US

V. Phone/Fax

Practice location:
  • Phone: 877-733-1067
  • Fax:
Mailing address:
  • Phone: 804-659-1363
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 5
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number
License Number StateNULL
# 6
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: EYOHKA KAMARA
Title or Position: OWNER/PRESIDENT
Credential: RN
Phone: 804-659-1363