Provider Demographics
NPI:1669210209
Name:JAROMA DISTINCT CARE INC
Entity type:Organization
Organization Name:JAROMA DISTINCT CARE INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RITA
Authorized Official - Middle Name:EMANKWA
Authorized Official - Last Name:ELAD
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-550-3685
Mailing Address - Street 1:15800 PERKINS LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20716-1641
Mailing Address - Country:US
Mailing Address - Phone:240-929-4276
Mailing Address - Fax:240-334-2851
Practice Address - Street 1:15800 PERKINS LN
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-1641
Practice Address - Country:US
Practice Address - Phone:240-929-4276
Practice Address - Fax:240-334-2851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit
No320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children