Provider Demographics
NPI:1376061069
Name:SHAMMAH CARES INC
Entity Type:Organization
Organization Name:SHAMMAH CARES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:BESEM
Authorized Official - Middle Name:
Authorized Official - Last Name:MILD-EBOT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-486-5137
Mailing Address - Street 1:1629 K ST NW STE 300
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-1631
Mailing Address - Country:US
Mailing Address - Phone:240-486-5137
Mailing Address - Fax:
Practice Address - Street 1:6475 NEW HAMPSHIRE AVE STE 630
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3283
Practice Address - Country:US
Practice Address - Phone:240-486-5137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-01
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Yes253Z00000XAgenciesIn Home Supportive Care
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center