Provider Demographics
NPI:1841576956
Name:PRAISE HOME HEALTH SERVICES
Entity Type:Organization
Organization Name:PRAISE HOME HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PEACE
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHUCHURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-450-4122
Mailing Address - Street 1:143 KENNEDY ST NW
Mailing Address - Street 2:SUITE 03
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5228
Mailing Address - Country:US
Mailing Address - Phone:202-450-4122
Mailing Address - Fax:202-450-4123
Practice Address - Street 1:143 KENNEDY ST NW
Practice Address - Street 2:SUITE 03
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5228
Practice Address - Country:US
Practice Address - Phone:202-450-4122
Practice Address - Fax:202-450-4123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN57612251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management