Healthcare Provider Details

I. General information

NPI: 1194311266
Provider Name (Legal Business Name): YACHAD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/14/2020
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8720 GEORGIA AVE STE 705
SILVER SPRING MD
20910-3967
US

IV. Provider business mailing address

8720 GEORGIA AVE STE 705
SILVER SPRING MD
20910-3967
US

V. Phone/Fax

Practice location:
  • Phone: 301-520-4647
  • Fax:
Mailing address:
  • Phone: 301-520-4647
  • 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: AUDREY LYON
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 202-296-8563