Provider Demographics
NPI:1417548397
Name:KHALEENA HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:KHALEENA HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATARSHA
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-903-7147
Mailing Address - Street 1:2018 N ANVIL LN
Mailing Address - Street 2:
Mailing Address - City:TEMPLE HILLS
Mailing Address - State:MD
Mailing Address - Zip Code:20748-4275
Mailing Address - Country:US
Mailing Address - Phone:202-903-7147
Mailing Address - Fax:
Practice Address - Street 1:4400 STAMP RD STE 406A
Practice Address - Street 2:
Practice Address - City:TEMPLE HILLS
Practice Address - State:MD
Practice Address - Zip Code:20748-6730
Practice Address - Country:US
Practice Address - Phone:202-903-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-02
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care