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General NPI Number Information
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NPI Number | 1154966646
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Entity Type | Organization
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Legal Business Name | AMAZING HEALTHCARE CLINIC CORPORATION
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Dates
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Enumeration Date | 11/08/2019
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Last Update Date | 11/07/2024
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Provider Practice Location Address
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Address Line | 6495 NEW HAMPSHIRE AVE # A203
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City | HYATTSVILLE
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State | MD
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Zip | 20783-3245
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Country | US
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Telephone | 301-798-5583
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Fax |
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Provider Business Mailing Address
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Address Line | 6495 NEW HAMPSHIRE AVE # A203
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City | HYATTSVILLE
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State | MD
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Zip | 20783-3245
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Country | US
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Telephone | 301-798-5583
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Fax | 301-798-6260
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Authorized Official
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Title or Position | PROVIDER
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Name | BOSEDE M ADELEYE
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Credential | NP
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Telephone | 301-512-9449
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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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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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