Provider Demographics
NPI:1528586112
Name:SUUNA CHI HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:SUUNA CHI HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FLORENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:NWANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-803-5391
Mailing Address - Street 1:13639 BALTIMORE AVE
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-5095
Mailing Address - Country:US
Mailing Address - Phone:301-604-4830
Mailing Address - Fax:
Practice Address - Street 1:13639 BALTIMORE AVE
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20707-5095
Practice Address - Country:US
Practice Address - Phone:301-604-4830
Practice Address - Fax:301-604-4929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-02
Last Update Date:2020-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363LP0808X
MDR128581363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty