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General NPI Number Information
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NPI Number | 1982844015
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Entity Type | Organization
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Legal Business Name | FAVOUS HEALTHCARE SERVICES
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 2909 EAGLES NEST DR
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City | BOWIE
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State | MD
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Zip | 20716-3905
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Country | US
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Telephone | 301-357-5432
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Fax | 301-805-0634
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Provider Business Mailing Address
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Address Line | 2909 EAGLES NEST DR
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City | BOWIE
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State | MD
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Zip | 20716-3905
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Country | US
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Telephone | 301-357-5432
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Fax | 301-805-0634
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | OLUSEYI OGUNJUYIGBE
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Credential |
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Telephone | 301-357-5432
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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 | R2605
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License Number State | MD
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