Provider Demographics
NPI:1902184229
Name:TIMELY PERFORMANCE CARE INC
Entity Type:Organization
Organization Name:TIMELY PERFORMANCE CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:GOHLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-728-0354
Mailing Address - Street 1:7410 GEORGIA AVE NW
Mailing Address - Street 2:#4
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-1778
Mailing Address - Country:US
Mailing Address - Phone:202-506-2716
Mailing Address - Fax:
Practice Address - Street 1:7410 GEORGIA AVE NW
Practice Address - Street 2:#4
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1778
Practice Address - Country:US
Practice Address - Phone:202-506-2716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC052210300251C00000X, 251E00000X, 251G00000X, 253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based
No253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC052210300Medicaid