Provider Demographics
NPI:1295442077
Name:A&A HOMECARE AND MEDICAL PROVISION WITH MEDICAL STAFFING LLC
Entity type:Organization
Organization Name:A&A HOMECARE AND MEDICAL PROVISION WITH MEDICAL STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ALT. DIRECTOR/SERVICE COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:GISSELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-640-8687
Mailing Address - Street 1:7211 PARK HEIGHTS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:PIKESVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-5497
Mailing Address - Country:US
Mailing Address - Phone:301-640-8687
Mailing Address - Fax:
Practice Address - Street 1:1420 N. STREET SW
Practice Address - Street 2:STE 102, 105, 107
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005
Practice Address - Country:US
Practice Address - Phone:301-408-8763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-01
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes253Z00000XAgenciesIn Home Supportive CareGroup - Multi-Specialty
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty