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General NPI Number Information
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NPI Number | 1629302575
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Entity Type | Organization
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Legal Business Name | GOOD HEALTH, HEALTH CARE AGENCY, INC.
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Dates
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Enumeration Date | 09/24/2009
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Last Update Date | 11/18/2009
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Provider Practice Location Address
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Address Line | 143 KENNEDY ST NW STE 3
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City | WASHINGTON
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State | DC
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Zip | 20011-5270
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Country | US
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Telephone | 240-401-8764
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Fax |
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Provider Business Mailing Address
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Address Line | 6480 NEW HAMPSHIRE AVE STE 305
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City | TAKOMA PARK
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State | MD
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Zip | 20912-4716
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Country | US
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Telephone | 301-270-4705
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LAWRENCE CHUCK OMERENNAH
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Credential |
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Telephone | 240-401-8764
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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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