Provider Demographics
NPI:1316371503
Name:FELICITA HOME HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:FELICITA HOME HEALTH CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CECILIA
Authorized Official - Middle Name:NKENGANYI
Authorized Official - Last Name:MOKAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-421-5821
Mailing Address - Street 1:6210 N CAPITOL ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1416
Mailing Address - Country:US
Mailing Address - Phone:240-421-5821
Mailing Address - Fax:301-560-8058
Practice Address - Street 1:6908 SCOTCH DR
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5321
Practice Address - Country:US
Practice Address - Phone:240-421-5821
Practice Address - Fax:301-560-8058
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-25
Last Update Date:2013-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDNSA-0205251E00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care