Healthcare Provider Details

I. General information

NPI: 1518150770
Provider Name (Legal Business Name): EMMACH SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2007
Last Update Date: 08/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7333 NEW HAMPSHIRE AVE SUITE 905
TAKOMA PARK MD
20912-6958
US

IV. Provider business mailing address

7333 NEW HAMPSHIRE AVE SUITE 905
TAKOMA PARK MD
20912-6958
US

V. Phone/Fax

Practice location:
  • Phone: 301-445-2258
  • Fax: 301-445-1098
Mailing address:
  • Phone: 301-445-2258
  • Fax: 301-445-1098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberR2414
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code305S00000X
TaxonomyPoint of Service
License NumberLC2248
License Number StateMD

VIII. Authorized Official

Name: MR. JOSEPH ATSIANZALE WAKHANALA
Title or Position: PRESIDENT
Credential: LCPC
Phone: 301-445-2258