Provider Demographics
NPI:1275394389
Name:INGLESIDE AT HOME INC
Entity Type:Organization
Organization Name:INGLESIDE AT HOME INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGDAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-357-9612
Mailing Address - Street 1:2275 RESEARCH BLVD STE 450
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3853
Mailing Address - Country:US
Mailing Address - Phone:703-357-9612
Mailing Address - Fax:
Practice Address - Street 1:3050 MILITARY RD NW BLDG 1
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-1344
Practice Address - Country:US
Practice Address - Phone:703-552-6140
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care