Provider Demographics
NPI:1679242630
Name:PLEROMA CARE INCORPORATED
Entity Type:Organization
Organization Name:PLEROMA CARE INCORPORATED
Other - Org Name:PLEROMA HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:EJIMNKEONYE
Authorized Official - Middle Name:MARTHA
Authorized Official - Last Name:OSEMENE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-343-6829
Mailing Address - Street 1:11830 FEDERALIST WAY APT 21
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-7892
Mailing Address - Country:US
Mailing Address - Phone:571-343-8629
Mailing Address - Fax:
Practice Address - Street 1:11830 FEDERALIST WAY APT 21
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-7892
Practice Address - Country:US
Practice Address - Phone:571-343-8629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-12
Last Update Date:2024-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251K00000XAgenciesPublic Health or Welfare
No253Z00000XAgenciesIn Home Supportive Care
No261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No276400000XHospital UnitsRehabilitation, Substance Use Disorder Unit