Healthcare Provider Details

I. General information

NPI: 1558622183
Provider Name (Legal Business Name): VALENTINE NJAMNSHI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/30/2012
Last Update Date: 05/06/2024
Certification Date: 05/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6353 64TH AVE
RIVERDALE MD
20737-1501
US

IV. Provider business mailing address

6353 64TH AVE
RIVERDALE MD
20737-1501
US

V. Phone/Fax

Practice location:
  • Phone: 202-600-1775
  • Fax:
Mailing address:
  • Phone: 202-600-1775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: