Provider Demographics
NPI:1629302575
Name:GOOD HEALTH, HEALTH CARE AGENCY, INC.
Entity Type:Organization
Organization Name:GOOD HEALTH, HEALTH CARE AGENCY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:CHUCK
Authorized Official - Last Name:OMERENNAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-401-8764
Mailing Address - Street 1:6480 NEW HAMPSHIRE AVE STE 305
Mailing Address - Street 2:
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4716
Mailing Address - Country:US
Mailing Address - Phone:301-270-4705
Mailing Address - Fax:
Practice Address - Street 1:143 KENNEDY ST NW STE 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5270
Practice Address - Country:US
Practice Address - Phone:240-401-8764
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-24
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health