Provider Demographics
NPI:1861013724
Name:PRAISE HOME HEALTHCARE
Entity Type:Organization
Organization Name:PRAISE HOME HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:PEACE
Authorized Official - Middle Name:
Authorized Official - Last Name:KACHUCHURU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-367-6378
Mailing Address - Street 1:3022 JAVIER RD STE 217
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22031-4646
Mailing Address - Country:US
Mailing Address - Phone:301-367-6378
Mailing Address - Fax:267-200-0795
Practice Address - Street 1:520 PUSEY AVE STE 160
Practice Address - Street 2:
Practice Address - City:DARBY
Practice Address - State:PA
Practice Address - Zip Code:19023-3312
Practice Address - Country:US
Practice Address - Phone:301-367-6378
Practice Address - Fax:267-200-0795
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-01
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health