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General NPI Number Information
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NPI Number | 1922755800
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Entity Type | Organization
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Legal Business Name | RADIANCE ENTERPRISE
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Dates
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Enumeration Date | 03/09/2022
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Last Update Date | 11/05/2025
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Provider Practice Location Address
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Address Line | 4645 NANNIE HELEN BURROUGHS AVE NE STE 308
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City | WASHINGTON
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State | DC
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Zip | 20019-3622
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Country | US
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Telephone | 240-481-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 4546 NANNIE HELEN BURROUGHS AVENUE NE SUITE 308
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City | WASHINGTON
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State | DC
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Zip | 20019
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Country | US
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Telephone | 240-481-5212
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | VALERY NGUH
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Credential |
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Telephone | 240-481-5212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WH0200X
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Taxonomy Name | Home Health Registered Nurse
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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 | 376J00000X
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Taxonomy Name | Homemaker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 364SH0200X
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Taxonomy Name | Home Health Clinical Nurse Specialist
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 374U00000X
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Taxonomy Name | Home Health Aide
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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