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General NPI Number Information
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NPI Number | 1033374640
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Entity Type | Organization
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Legal Business Name | JEMISUN HOME CARE LLC
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Dates
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Enumeration Date | 07/23/2008
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Last Update Date | 07/23/2008
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Provider Practice Location Address
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Address Line | 14201 LAUREL PARK DR SUITE # 226
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City | LAUREL
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State | MD
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Zip | 20707-5203
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Country | US
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Telephone | 301-879-2160
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Fax | 301-891-0182
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Provider Business Mailing Address
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Address Line | PO BOX 10866
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City | SILVER SPRING
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State | MD
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Zip | 20914-0866
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Country | US
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Telephone | 301-879-2160
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Fax | 301-879-0182
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Authorized Official
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Title or Position | DIRECTOR OF NURSING/ ADMINISTRATOR
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Name | MS. JUDITH ULOMA NWAKANMA
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Credential | RN BSN
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Telephone | 301-879-2160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | R2589
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License Number State | MD
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