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General NPI Number Information
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NPI Number | 1619554144
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Entity Type | Organization
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Legal Business Name | ADRA GENERAL SERVICES
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Dates
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Enumeration Date | 03/29/2021
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Last Update Date | 03/29/2021
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Provider Practice Location Address
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Address Line | 13007 AUGUSTAS PROGRESS DRIVE
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City | BOWIE
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State | MD
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Zip | 20720-6315
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Country | US
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Telephone | 301-455-8198
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Fax |
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Provider Business Mailing Address
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Address Line | 13007 AUGUSTAS PROGRESS DRIVE
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City | BOWIE
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State | MD
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Zip | 20720-6315
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Country | US
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Telephone | 301-455-8198
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. RASHEED JOHNSON
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Credential | RPT
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Telephone | 301-455-8198
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 372600000X
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Taxonomy Name | Adult Companion
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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