Provider Demographics
NPI:1275296287
Name:NEC HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:NEC HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MENSAH
Authorized Official - Suffix:
Authorized Official - Credentials:MANAGER
Authorized Official - Phone:301-437-1236
Mailing Address - Street 1:2759 MARTIN LUTHER KING JR AVE SE STE 207
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2646
Mailing Address - Country:US
Mailing Address - Phone:301-437-1236
Mailing Address - Fax:866-577-2896
Practice Address - Street 1:2759 MARTIN LUTHER KING JR AVE SE STE 207
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2646
Practice Address - Country:US
Practice Address - Phone:301-437-1236
Practice Address - Fax:866-577-2896
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NEW ERA CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-17
Last Update Date:2021-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty