Provider Demographics
NPI:1811940513
Name:JD NURSING & MANAGEMENT SER
Entity type:Organization
Organization Name:JD NURSING & MANAGEMENT SER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:NNEBEDUM
Authorized Official - Last Name:IBE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-722-7776
Mailing Address - Street 1:6120 KANSAS AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1328
Mailing Address - Country:US
Mailing Address - Phone:202-722-7776
Mailing Address - Fax:202-722-7785
Practice Address - Street 1:6120 KANSAS AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1328
Practice Address - Country:US
Practice Address - Phone:202-722-7776
Practice Address - Fax:202-722-7785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC04-5-4251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
097064Medicare ID - Type Unspecified