Provider Demographics
NPI:1649722158
Name:CHIAMA GROUP, INC.
Entity type:Organization
Organization Name:CHIAMA GROUP, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CHINENYE
Authorized Official - Middle Name:STAFFORD
Authorized Official - Last Name:ASOBIEREONWU
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:919-802-7911
Mailing Address - Street 1:6709 BRIARCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:MD
Mailing Address - Zip Code:20735-4002
Mailing Address - Country:US
Mailing Address - Phone:919-802-7911
Mailing Address - Fax:301-868-2241
Practice Address - Street 1:6709 BRIARCLIFF DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:MD
Practice Address - Zip Code:20735-4002
Practice Address - Country:US
Practice Address - Phone:919-802-7911
Practice Address - Fax:301-868-2241
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHIAMA GROUP, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16AL1092-B310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility