Provider Demographics
NPI:1255020608
Name:MARYAM HOME HEALTH LLC
Entity type:Organization
Organization Name:MARYAM HOME HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ZEINAB
Authorized Official - Middle Name:M
Authorized Official - Last Name:AHMED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-869-9325
Mailing Address - Street 1:3453 CASTLE HILL DR
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22193-5319
Mailing Address - Country:US
Mailing Address - Phone:240-869-9325
Mailing Address - Fax:
Practice Address - Street 1:3453 CASTLE HILL DR
Practice Address - Street 2:
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22193-5319
Practice Address - Country:US
Practice Address - Phone:240-869-9325
Practice Address - Fax:571-589-0141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-02
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No385H00000XRespite Care FacilityRespite Care