=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962830125
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | NURSING UNLIMITED SERVICES, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/28/2013
-----------------------------------------------------
Last Update Date | 10/28/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1721 29TH ST SE #2
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-233-1404
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1721 29TH ST SE #2
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20020
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | HOME HEALTH AIDE
-----------------------------------------------------
Name | ROGER KEETON
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 540-233-1404
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------