Provider Demographics
NPI: | 1700212057 |
---|---|
Name: | GREAT EXPECTATIONS |
Entity Type: | Organization |
Organization Name: | GREAT EXPECTATIONS |
Other - Org Name: | GREATER COMPASSION HOME HEALTH CARE,INC |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | ADMINISTRATOR |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | ABRAHAM |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | KOROMA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 301-200-8010 |
Mailing Address - Street 1: | 6490 LANDOVER RD |
Mailing Address - Street 2: | SUITE D ROOM #6 |
Mailing Address - City: | CHEVERLY |
Mailing Address - State: | MD |
Mailing Address - Zip Code: | 20785 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 301-200-8010 |
Mailing Address - Fax: | 301-841-8016 |
Practice Address - Street 1: | 6490 LANDOVER RD |
Practice Address - Street 2: | SUITE D ROOM #6 |
Practice Address - City: | CHEVERLY |
Practice Address - State: | MD |
Practice Address - Zip Code: | 20785-1443 |
Practice Address - Country: | US |
Practice Address - Phone: | 301-200-8010 |
Practice Address - Fax: | 301-841-8016 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-09-18 |
Last Update Date: | 2018-03-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
VA | HCO171179 | 163WC0400X, 163WC2100X, 163WH0200X, 163WP0200X, 163WW0000X, 164W00000X, 252Y00000X |
MD | 130702 | 251B00000X, 251E00000X, 251F00000X, 253Z00000X, 320900000X, 385H00000X, 385HR2060X |
VA | HCO181179 | 374U00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health | Group - Multi-Specialty | |
No | 163WC0400X | Nursing Service Providers | Registered Nurse | Case Management | Group - Multi-Specialty |
No | 163WC2100X | Nursing Service Providers | Registered Nurse | Continence Care | Group - Multi-Specialty |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 163WP0200X | Nursing Service Providers | Registered Nurse | Pediatrics | Group - Multi-Specialty |
No | 163WW0000X | Nursing Service Providers | Registered Nurse | Wound Care | Group - Multi-Specialty |
No | 164W00000X | Nursing Service Providers | Licensed Practical Nurse | Group - Multi-Specialty | |
No | 251B00000X | Agencies | Case Management | Group - Multi-Specialty | |
No | 251F00000X | Agencies | Home Infusion | Group - Multi-Specialty | |
No | 252Y00000X | Agencies | Early Intervention Provider Agency | Group - Multi-Specialty | |
No | 253Z00000X | Agencies | In Home Supportive Care | Group - Multi-Specialty | |
No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | Group - Multi-Specialty | |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty | |
No | 385H00000X | Respite Care Facility | Respite Care | Group - Multi-Specialty | |
No | 385HR2060X | Respite Care Facility | Respite Care | Respite Care, Intellectual and/or Developmental Disabilities, Child |