Provider Demographics
NPI:1073996740
Name:JD NURSING & MANAGEMENT SERVICES INC.
Entity Type:Organization
Organization Name:JD NURSING & MANAGEMENT SERVICES INC.
Other - Org Name:JD NURSING & MANAGEMENT SERVICES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:
Authorized Official - First Name:LYCIA
Authorized Official - Middle Name:BEYONGE
Authorized Official - Last Name:EKOLLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-413-1511
Mailing Address - Street 1:3823 64TH AVE
Mailing Address - Street 2:#104
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20784-1830
Mailing Address - Country:US
Mailing Address - Phone:240-413-1511
Mailing Address - Fax:
Practice Address - Street 1:3823 64TH AVE
Practice Address - Street 2:#104
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20784-1830
Practice Address - Country:US
Practice Address - Phone:240-413-1511
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11368251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health