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General NPI Number Information
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NPI Number | 1962955930
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Entity Type | Organization
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Legal Business Name | BENTILDA HEALTHCARE SERVICES
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Dates
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Enumeration Date | 07/26/2016
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 13526 COLLINGWOOD TER
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City | SILVER SPRING
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State | MD
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Zip | 20904
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Country | US
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Telephone | 301-785-8504
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Fax | 301-384-1740
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Provider Business Mailing Address
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Address Line | 13526 COLLINGWOOD TER
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City | SILVER SPRING
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State | MD
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Zip | 20904-1425
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Country | US
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Telephone | 301-785-8504
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Fax | 301-384-1740
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MS. ETHEL NGOZI NWANNA
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Credential |
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Telephone | 301-785-8504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 121012
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License Number State | MD
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