Provider Demographics
NPI:1225684467
Name:LATTER RAIN INCORPORATED
Entity Type:Organization
Organization Name:LATTER RAIN INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LILLIAN
Authorized Official - Middle Name:U
Authorized Official - Last Name:EZEJI-OKOYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-643-7642
Mailing Address - Street 1:15824 BUENA VISTA DR
Mailing Address - Street 2:
Mailing Address - City:DERWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:20855-2658
Mailing Address - Country:US
Mailing Address - Phone:240-643-7642
Mailing Address - Fax:301-847-0546
Practice Address - Street 1:15824 BUENA VISTA DR
Practice Address - Street 2:
Practice Address - City:DERWOOD
Practice Address - State:MD
Practice Address - Zip Code:20855-2658
Practice Address - Country:US
Practice Address - Phone:240-643-7642
Practice Address - Fax:301-847-0546
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LATTER RAIN INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-14
Last Update Date:2019-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
No251E00000XAgenciesHome Health
No320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental DisabilitiesGroup - Single Specialty