MEDICARE: DEBE ENTERPRISES INC

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

General Provider Information

NPI Number	:	1912738253
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DEBE ENTERPRISES INC

Provider Business Mailing Address
First Line	:	1219 EDENVILLE DR
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1704
Country	:	US
Telephone Number	:	301-922-7208
Fax Number	:

Provider Business Practice Location Address
First Line	:	1219 EDENVILLE DR
Second Line	:
City	:	DISTRICT HEIGHTS
State	:	MD
Zip	:	20747-1704
Country	:	US
Telephone Number	:	301-922-7208
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. TAWANA MADINA BYNUM
Credential	:
Telephone Number	:	301-922-7208

Provider Enumeration Date	:	08/09/2024
Last Update Date	:	08/09/2024

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