Provider Demographics
NPI:1821865858
Name:HAJMOUD HOMECAREHEALTH AGENCY LLC
Entity Type:Organization
Organization Name:HAJMOUD HOMECAREHEALTH AGENCY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:HAJI
Authorized Official - Middle Name:ZAINAB
Authorized Official - Last Name:SACCOH
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:240-476-9385
Mailing Address - Street 1:12308 FOYETTE LN
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20772-9308
Mailing Address - Country:US
Mailing Address - Phone:240-476-9385
Mailing Address - Fax:
Practice Address - Street 1:12308 FOYETTE LN
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20772-9308
Practice Address - Country:US
Practice Address - Phone:240-476-9385
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health