MEDICARE: IN HIS NAME JUSTICE, EDUCATION & SOCIAL SERVICES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	1041C0700X	Clinical Social Worker
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1326450289
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IN HIS NAME JUSTICE, EDUCATION & SOCIAL SERVICES

Provider Business Mailing Address
First Line	:	1903 BELLE HAVEN DR
Second Line	:	SUITE 202
City	:	LANDOVER
State	:	MD
Zip	:	20785-4054
Country	:	US
Telephone Number	:	240-480-4305
Fax Number	:

Provider Business Practice Location Address
First Line	:	1903 BELLE HAVEN DR
Second Line	:	SUITE 202
City	:	LANDOVER
State	:	MD
Zip	:	20785-4054
Country	:	US
Telephone Number	:	240-480-4305
Fax Number	:

Authorized Official
Title or Position	:	EXEUCTIVE DIRECTOR
Name	:	MS. CHRISTINE LOIS GALLOWAY
Credential	:
Telephone Number	:	240-480-4305

Provider Enumeration Date	:	05/27/2014
Last Update Date	:	05/27/2014

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