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General NPI Number Information
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NPI Number | 1750936118
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Entity Type | Organization
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Legal Business Name | FLAWLESS HOME HEALTH SERVICE, LLC
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Dates
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Enumeration Date | 08/02/2019
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Last Update Date | 08/02/2019
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Provider Practice Location Address
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Address Line | 12606 NICHOLS PROMISE DR
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City | BOWIE
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State | MD
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Zip | 20720-5602
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Country | US
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Telephone | 301-464-5300
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Fax | 301-464-5301
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Provider Business Mailing Address
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Address Line | 12606 NICHOLS PROMISE DR
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City | BOWIE
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State | MD
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Zip | 20720-5602
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Country | US
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Telephone | 202-309-4674
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Fax | 301-464-5301
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Authorized Official
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Title or Position | OWNER/ DIRECTOR OF NURSING
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Name | MRS. FATMATA JALLOH-CHAMBERLAIN
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Credential |
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Telephone | 202-309-4674
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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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