Provider Demographics
NPI:1295259794
Name:ENERGIZED NURSES HOME HEALTH CARE INCORPORATED
Entity type:Organization
Organization Name:ENERGIZED NURSES HOME HEALTH CARE INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER/DIRECTOR OF NURSING
Authorized Official - Prefix:
Authorized Official - First Name:MADINATU
Authorized Official - Middle Name:
Authorized Official - Last Name:KOROMA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-358-4948
Mailing Address - Street 1:9420 ANNAPOLIS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-3021
Mailing Address - Country:US
Mailing Address - Phone:301-358-4948
Mailing Address - Fax:301-358-1771
Practice Address - Street 1:9420 ANNAPOLIS RD STE 201
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-3021
Practice Address - Country:US
Practice Address - Phone:301-358-4948
Practice Address - Fax:301-358-1771
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-27
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care
No385HR2055XRespite Care FacilityRespite CareRespite Care, Mental Illness, Child