Provider Demographics
NPI:1326602434
Name:AMIABLE ACCESS HEALTHCARE INC
Entity Type:Organization
Organization Name:AMIABLE ACCESS HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:OMOIJUANFO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-957-4114
Mailing Address - Street 1:1701 STONE IVY PL
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5717
Mailing Address - Country:US
Mailing Address - Phone:202-957-4114
Mailing Address - Fax:
Practice Address - Street 1:8511 HARFORD RD STE D
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234-4670
Practice Address - Country:US
Practice Address - Phone:202-957-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-24
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities