Provider Demographics
NPI:1437510997
Name:BERHAN HOME HEALTH AGENCY
Entity Type:Organization
Organization Name:BERHAN HOME HEALTH AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED INSTRUCTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:B
Authorized Official - Last Name:UZOMA
Authorized Official - Suffix:
Authorized Official - Credentials:HHA
Authorized Official - Phone:301-339-4396
Mailing Address - Street 1:3401 ROBEY TERRACE #304
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904
Mailing Address - Country:US
Mailing Address - Phone:240-505-4114
Mailing Address - Fax:
Practice Address - Street 1:3401 ROBEY TER APT 304
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7774
Practice Address - Country:US
Practice Address - Phone:240-505-4114
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-11
Last Update Date:2016-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHHA11840302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization