Provider Demographics
NPI:1083090708
Name:HHA
Entity Type:Organization
Organization Name:HHA
Other - Org Name:CNA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:MR
Authorized Official - First Name:AMSTRONG
Authorized Official - Middle Name:AJONG
Authorized Official - Last Name:NJUALEM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-413-6483
Mailing Address - Street 1:3320 DODGE PARK RD APT 103
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20785-2116
Mailing Address - Country:US
Mailing Address - Phone:240-413-6483
Mailing Address - Fax:
Practice Address - Street 1:3320 DODGE PARK RD APT 103
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20785-2116
Practice Address - Country:US
Practice Address - Phone:240-413-6483
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CNA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-04
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA11393251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC061628877Medicaid
DC061628877Medicare Oscar/Certification