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General NPI Number Information
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NPI Number | 1124992961
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Entity Type | Organization
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Legal Business Name | AGNES IOO HEALTHCARE SERVICES, INC.
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Dates
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Enumeration Date | 10/03/2025
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Last Update Date | 10/03/2025
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Provider Practice Location Address
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Address Line | 11908 PROSPECT VIEW AVE
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City | GLENN DALE
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State | MD
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Zip | 20769-9473
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Country | US
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Telephone | 240-413-3598
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Fax |
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Provider Business Mailing Address
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Address Line | 11908 PROSPECT VIEW AVE
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City | GLENN DALE
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State | MD
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Zip | 20769-9473
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Country | US
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Telephone | 240-413-3598
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | AGNES OLUYEMI
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Credential |
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Telephone | 240-413-3598
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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 |
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License Number State |
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