Healthcare Provider Details

I. General information

NPI: 1164787560
Provider Name (Legal Business Name): HAIMANOT ARITI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2012
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6327 61ST AVE
RIVERDALE MD
20737-1406
US

IV. Provider business mailing address

215 BROADUS ST
STURGIS MI
49091-1384
US

V. Phone/Fax

Practice location:
  • Phone: 301-728-0570
  • Fax:
Mailing address:
  • Phone: 877-659-4500
  • Fax: 888-972-3891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License NumberHHA6806
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: