Healthcare Provider Details

I. General information

NPI: 1700453669
Provider Name (Legal Business Name): CLAUDIA HOUSE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/09/2021
Last Update Date: 06/09/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8912 TUCKERMAN LN
POTOMAC MD
20854-3168
US

IV. Provider business mailing address

PO BOX 60521
POTOMAC MD
20859-0521
US

V. Phone/Fax

Practice location:
  • Phone: 202-725-1944
  • Fax:
Mailing address:
  • Phone: 240-907-2139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: EDELINE CHARLES
Title or Position: REGISTERED NURSE
Credential:
Phone: 240-907-2139