Provider Demographics
NPI:1689215170
Name:OTIK HEALTH CARE SERVICES
Entity Type:Organization
Organization Name:OTIK HEALTH CARE SERVICES
Other - Org Name:OTIK HEALTH CARE SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF NURSING
Authorized Official - Prefix:MR
Authorized Official - First Name:HAN FORUM
Authorized Official - Middle Name:F
Authorized Official - Last Name:ENOW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-755-1953
Mailing Address - Street 1:8616 ACCOKEEK ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20724-1986
Mailing Address - Country:US
Mailing Address - Phone:443-525-5611
Mailing Address - Fax:
Practice Address - Street 1:8616 ACCOKEEK ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20724-1986
Practice Address - Country:US
Practice Address - Phone:443-525-5611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-05
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No385H00000XRespite Care FacilityRespite Care