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General NPI Number Information
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NPI Number | 1912302688
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Entity Type | Organization
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Legal Business Name | JERSIRA SHINDOH
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Dates
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Enumeration Date | 10/23/2014
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Last Update Date | 10/23/2014
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Provider Practice Location Address
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Address Line | 9873 GOOD LUCK RD APT 1
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City | LANHAM
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State | MD
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Zip | 20706-3230
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Country | US
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Telephone | 202-520-3689
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Fax |
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Provider Business Mailing Address
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Address Line | 9873 GOOD LUCK RD APT 1
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City | LANHAM
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State | MD
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Zip | 20706-3230
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Country | US
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Telephone | 202-520-3689
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Fax |
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Authorized Official
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Title or Position | HHA
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Name | MS. JERSIRA SHINDOH
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Credential |
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Telephone | 202-520-3689
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311ZA0620X
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Taxonomy Name | Adult Care Home Facility
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License Number | 10975
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License Number State | DC
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