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NPI Code Detail

MEDICARE: JERI HOPEFUL HAVEN LLC

MEDICARE: JERI HOPEFUL HAVEN LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1363LP0808XPsychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number : 1649106642
Entity Type Code : Organization
Provider Name (Legal Business Name) : JERI HOPEFUL HAVEN LLC
Provider Business Mailing Address
First Line : 3261 OLD WASHINGTON RD STE SCO1075
Second Line :
City : WALDORF
State : MD
Zip : 20602-3223
Country : US
Telephone Number : 240-463-6759
Fax Number :
Provider Business Practice Location Address
First Line : 3261 OLD WASHINGTON RD STE 2031
Second Line :
City : WALDORF
State : MD
Zip : 20602-3313
Country : US
Telephone Number : 240-463-6759
Fax Number :
Authorized Official
Title or Position : OWNER
Name : ANNE N ALLEN
Credential : PMHNP
Telephone Number : 240-463-6759
Provider Enumeration Date : 06/18/2026
Last Update Date : 06/19/2026

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Directions to “JERI HOPEFUL HAVEN LLC ” Practice Location

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