Healthcare Provider Details
I. General information
NPI: 1174763247
Provider Name (Legal Business Name): BOYO HEALTHCARE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/02/2009
Last Update Date: 03/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 E WAYNE AVE # M706
SILVER SPRING MD
20901-4264
US
IV. Provider business mailing address
25 E WAYNE AVE # M706
SILVER SPRING MD
20901-4264
US
V. Phone/Fax
- Phone: 301-370-8049
- Fax:
- Phone: 301-370-8049
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 101Y00000X |
| Taxonomy | Counselor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TM1800X |
| Taxonomy | Intellectual & Developmental Disabilities Psychologist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 164W00000X |
| Taxonomy | Licensed Practical Nurse |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 374U00000X |
| Taxonomy | Home Health Aide |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 376K00000X |
| Taxonomy | Nurse's Aide |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MRS.
PETRA
BIH
JUA
Title or Position: PRESIDENT
Credential: BSN RN
Phone: 301-370-8049