Provider Demographics
NPI:1265745509
Name:MT.ZION,INC
Entity type:Organization
Organization Name:MT.ZION,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:SAMWEL
Authorized Official - Last Name:MWASALWIBA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-891-1055
Mailing Address - Street 1:6480 NEW HAMPSHIRE AVE
Mailing Address - Street 2:303
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-4716
Mailing Address - Country:US
Mailing Address - Phone:301-891-1055
Mailing Address - Fax:
Practice Address - Street 1:9319 LBJ FWY STE 112
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-3440
Practice Address - Country:US
Practice Address - Phone:301-891-1055
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-15
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health