Provider Demographics
NPI:1851531974
Name:DAMBRIDGE HEALTH CARE, INC
Entity Type:Organization
Organization Name:DAMBRIDGE HEALTH CARE, INC
Other - Org Name:DAMBRIDGE HOME CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOATENG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:877-287-3079
Mailing Address - Street 1:2650 JEFFERSON DAVIS HWY UNIT 522
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:VA
Mailing Address - Zip Code:22555-3622
Mailing Address - Country:US
Mailing Address - Phone:540-300-1160
Mailing Address - Fax:877-904-3069
Practice Address - Street 1:2650 JEFFERSON DAVIS HWY UNIT 522
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:VA
Practice Address - Zip Code:22555-3622
Practice Address - Country:US
Practice Address - Phone:866-848-5449
Practice Address - Fax:877-904-3069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-02
Last Update Date:2020-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251G00000XAgenciesHospice Care, Community Based
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTHCA.0001211OtherCT. DEPT OF CONSUMER PROTECTION