Provider Demographics
NPI:1659673374
Name:HOLY FAMILY SERVICES, LLC
Entity Type:Organization
Organization Name:HOLY FAMILY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:D.O.N
Authorized Official - Prefix:MRS
Authorized Official - First Name:BENEDICTA
Authorized Official - Middle Name:VIGER
Authorized Official - Last Name:AZONGHO
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-404-9059
Mailing Address - Street 1:6210 N CAPITOL ST NW STE 6
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1416
Mailing Address - Country:US
Mailing Address - Phone:301-905-8752
Mailing Address - Fax:301-577-3813
Practice Address - Street 1:6210 N CAPITOL ST NW STE 6
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1416
Practice Address - Country:US
Practice Address - Phone:301-905-8752
Practice Address - Fax:301-577-3813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC300000099984313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility