Provider Demographics
NPI:1942826755
Name:CREDIBLE HOME HEALTH, LLC
Entity Type:Organization
Organization Name:CREDIBLE HOME HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:NTOH
Authorized Official - Last Name:MBANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-640-1728
Mailing Address - Street 1:413 37TH PL SE
Mailing Address - Street 2:APT 202
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-3216
Mailing Address - Country:US
Mailing Address - Phone:240-640-1728
Mailing Address - Fax:877-682-6518
Practice Address - Street 1:413 37TH PL SE
Practice Address - Street 2:APT 202
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-3216
Practice Address - Country:US
Practice Address - Phone:240-640-1728
Practice Address - Fax:877-682-6518
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-18
Last Update Date:2020-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home