Provider Demographics
NPI:1134676794
Name:HOME HEALTH AID
Entity Type:Organization
Organization Name:HOME HEALTH AID
Other - Org Name:HEALTHCARE
Other - Org Type:Other Name
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:MRS
Authorized Official - First Name:FONYUY
Authorized Official - Middle Name:JOAN
Authorized Official - Last Name:WONGE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:202-290-7151
Mailing Address - Street 1:5040 NEW HAMSHIRE AVE NORTHEAST WASHINTON DC
Mailing Address - Street 2:NORTHEAST
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011
Mailing Address - Country:US
Mailing Address - Phone:202-290-7151
Mailing Address - Fax:
Practice Address - Street 1:5040 NEW HAMPSHIRE AVE NW
Practice Address - Street 2:WASHINGTON DC 20011
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-4184
Practice Address - Country:US
Practice Address - Phone:202-290-7151
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHHA12236311500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)