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General NPI Number Information
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NPI Number | 1306750013
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Entity Type | Organization
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Legal Business Name | CHACHA IMPACT HEALTHCARE SERVICE LLC
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 12811 INNISBROOK DR
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City | BELTSVILLE
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State | MD
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Zip | 20705-1183
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Country | US
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Telephone | 240-374-3285
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Fax |
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Provider Business Mailing Address
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Address Line | 12811 INNISBROOK DR
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City | BELTSVILLE
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State | MD
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Zip | 20705-1183
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Country | US
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Telephone | 240-374-3285
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Fax |
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Authorized Official
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Title or Position | REGIATERED NURSE
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Name | NAOMIE MESIDOR
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Credential |
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Telephone | 240-374-3285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number |
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License Number State | NULL
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