Provider Demographics
NPI:1598248304
Name:ZETTA HEALTHCARE LLC
Entity Type:Organization
Organization Name:ZETTA HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PARTNER/CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARVEL
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-542-8509
Mailing Address - Street 1:145 W OSTEND ST STE 600
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-3774
Mailing Address - Country:US
Mailing Address - Phone:240-542-8509
Mailing Address - Fax:
Practice Address - Street 1:145 W OSTEND ST STE 600
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-3774
Practice Address - Country:US
Practice Address - Phone:240-542-8509
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251E00000XAgenciesHome Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251F00000XAgenciesHome Infusion
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies