=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407388960
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | AMIABLE HOME HEALTH INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/03/2017
-----------------------------------------------------
Last Update Date | 04/03/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10120 BIGNONIA DR
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-285-8981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 10120 BIGNONIA DR
-----------------------------------------------------
City | LAUREL
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20708-3188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-285-8981
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RAZIA SEBULIBA
-----------------------------------------------------
Credential | NP-C
-----------------------------------------------------
Telephone | 202-285-8981
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number | R4023
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------