MEDICARE: BLANCHE AMEI SAMA

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
1	251S00000X	Community/Behavioral Health Agency
2	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1891499398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLANCHE AMEI SAMA

Provider Business Mailing Address
First Line	:	7540 NEWBERRY LN
Second Line	:
City	:	LANHAM
State	:	MD
Zip	:	20706-3769
Country	:	US
Telephone Number	:	240-790-2862
Fax Number	:

Provider Business Practice Location Address
First Line	:	6300 HEADEN JORDAN AVE
Second Line	:
City	:	RIVERDALE
State	:	MD
Zip	:	20737-1431
Country	:	US
Telephone Number	:	240-658-5638
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/28/2023
Last Update Date	:	07/20/2023

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Directions to “ BLANCHE AMEI SAMA ” Practice Location

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