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General NPI Number Information
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NPI Number | 1578822292
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Entity Type | Individual
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Provider Name | GETACHEW GODE
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Gender | Male
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Dates
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Enumeration Date | 05/15/2012
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Last Update Date | 03/06/2018
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Provider Practice Location Address
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Address Line | 1008 ANNE ST APT 1008
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City | TAKOMA PARK
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State | MD
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Zip | 20912-7402
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Country | US
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Telephone | 202-280-0108
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Fax |
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Provider Business Mailing Address
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Address Line | 1008 ANNE ST APT 1008
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City | TAKOMA PARK
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State | MD
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Zip | 20912-7402
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Country | US
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Telephone | 202-280-0108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number | HHA0991
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License Number State | DC
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