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Individual provider Active NPI Home Health Aide · Washington, DC

NPI 1184190068 · NPPES record last updated Oct 18, 2018

Key facts

NPI
1184190068
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
License
HHA14046 (DC)
Practice address
821 Kennedy St NW
Washington, DC 20011-2913
Phone
(202) 558-6084
Fax
(202) 722-1726
NPI assigned
Oct 18, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
HHA14046DCMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
ABA Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X HHA14046 DC Yes

Addresses

Primary practice location

821 Kennedy St NW
Washington, DC 20011-2913

Mailing address

6813 W Forest Rd
Hyattsville, MD 20785-3332
Phone (202) 722-1725

Other providers in Washington, DC

All providers in Washington, DC · Home Health Aide in District of Columbia

Sources for this page

Verify at the official NPI Registry.