Provider Demographics
NPI:1922773183
Name:FRONTLINE HEALTHCARE CORP.
Entity Type:Organization
Organization Name:FRONTLINE HEALTHCARE CORP.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:ADAORA
Authorized Official - Middle Name:EDNA
Authorized Official - Last Name:OGBUACHI
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:301-437-4344
Mailing Address - Street 1:6505 OAK FOREST CT
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-3167
Mailing Address - Country:US
Mailing Address - Phone:301-437-4344
Mailing Address - Fax:301-322-4886
Practice Address - Street 1:6005 LANDOVER RD STE 1
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1145
Practice Address - Country:US
Practice Address - Phone:301-437-4344
Practice Address - Fax:301-322-4886
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-10
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health