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General NPI Number Information
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NPI Number | 1073996740
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Entity Type | Organization
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Legal Business Name | JD NURSING & MANAGEMENT SERVICES INC.
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Dates
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Enumeration Date | 06/30/2015
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Last Update Date | 06/30/2015
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Provider Practice Location Address
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Address Line | 3823 64TH AVE #104
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City | HYATTSVILLE
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State | MD
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Zip | 20784-1830
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Country | US
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Telephone | 240-413-1511
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Fax |
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Provider Business Mailing Address
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Address Line | 3823 64TH AVE #104
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City | HYATTSVILLE
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State | MD
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Zip | 20784-1830
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Country | US
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Telephone | 240-413-1511
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Fax |
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Authorized Official
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Title or Position | HHA
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Name | LYCIA BEYONGE EKOLLE
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Credential |
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Telephone | 240-413-1511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | HHA11368
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License Number State | DC
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