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General NPI Number Information
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NPI Number | 1750021614
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Entity Type | Organization
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Legal Business Name | FRESH FRESH HEALTH CARE AGENCY LLC,
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Dates
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Enumeration Date | 03/30/2022
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Last Update Date | 04/07/2022
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Provider Practice Location Address
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Address Line | 7604 VICAR PL
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-2966
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Country | US
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Telephone | 202-823-9346
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Fax |
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Provider Business Mailing Address
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Address Line | 7604 VICAR PL
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-2966
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Country | US
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Telephone | 202-823-9346
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. ANDREA K RODNEY
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Credential | PHD DR PHYSIOLOGY
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Telephone | 202-823-9346
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282J00000X
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Taxonomy Name | Religious Nonmedical Health Care Institution
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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 | 103TA0700X
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Taxonomy Name | Adult Development & Aging Psychologist
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License Number |
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License Number State |
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