Provider Demographics
NPI:1275226714
Name:YAMA HEALTHCARE INC
Entity Type:Organization
Organization Name:YAMA HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:NICOLAS
Authorized Official - Middle Name:YEBIT
Authorized Official - Last Name:FONDOM
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:240-463-2106
Mailing Address - Street 1:2762 TOWN VIEW CIR
Mailing Address - Street 2:
Mailing Address - City:NEW WINDSOR
Mailing Address - State:MD
Mailing Address - Zip Code:21776-8710
Mailing Address - Country:US
Mailing Address - Phone:240-463-2106
Mailing Address - Fax:
Practice Address - Street 1:2762 TOWN VIEW CIR
Practice Address - Street 2:
Practice Address - City:NEW WINDSOR
Practice Address - State:MD
Practice Address - Zip Code:21776-8710
Practice Address - Country:US
Practice Address - Phone:240-463-2106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-31
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251E00000XAgenciesHome Health