Provider Demographics
NPI:1255158531
Name:EQUITA HEALTH LLC
Entity type:Organization
Organization Name:EQUITA HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TSHEGOFATSO
Authorized Official - Middle Name:KHANYISILE
Authorized Official - Last Name:TCHEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-431-2600
Mailing Address - Street 1:97 CAPITAL CT APT 1310
Mailing Address - Street 2:
Mailing Address - City:LARGO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-1082
Mailing Address - Country:US
Mailing Address - Phone:202-431-2600
Mailing Address - Fax:
Practice Address - Street 1:1714 E ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4610
Practice Address - Country:US
Practice Address - Phone:202-431-2600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities