Shabach Ministries Inc

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SHABACH MINISTRIES INC

Doing business as

SHABACH Health Center

Practice address

403 Brightseat Rd
Landover, MD 20785-4737

Phone

(301) 773-3600

NPI assigned

Aug 19, 2019

Organization subpart

Yes

Parent organization

SHABACH MINISTRIES INCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Georgina Agyekum Manzano

Title

Health Center Administrator

Phone

(301) 773-3600

Specialties & licenses 1

Addresses

Other names 1

• SHABACH Health Center Doing business as

Part of

Shabach Ministries Inc

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579219200000",
    "number": "1477100147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 BRIGHTSEAT RD",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207852414",
            "telephone_number": "301-773-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 BRIGHTSEAT RD",
            "city": "LANDOVER",
            "state": "MD",
            "postal_code": "207854737",
            "telephone_number": "301-773-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHABACH MINISTRIES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHABACH MINISTRIES INC",
        "enumeration_date": "2019-08-19",
        "last_updated": "2020-01-17",
        "certification_date": "2020-01-17",
        "status": "A",
        "authorized_official_last_name": "MANZANO",
        "authorized_official_first_name": "GEORGINA",
        "authorized_official_middle_name": "AGYEKUM",
        "authorized_official_title_or_position": "HEALTH CENTER ADMINISTRATOR",
        "authorized_official_telephone_number": "301-773-3600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SHABACH Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Thomas Bradley Segree
• Nicole Angela Sergeant
• Devin Sexton
• Grace Sexton
• Ida Seyedzare
• Danielle Shafer
• Joan D Shapiro, M.D.
• Stacey Sharples, COTA
• Nana Shehu
• Candace Nayisha Shillingford

• Health Service Clinic/Center in Landover, MD
• Providers in Landover, MD by specialty
• Health Service Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.