Provider Demographics
NPI:1063891018
Name:NISSI HOMES LLP
Entity type:Organization
Organization Name:NISSI HOMES LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR QUALITY ASSURANCE
Authorized Official - Prefix:DR
Authorized Official - First Name:JEAN
Authorized Official - Middle Name:JULES
Authorized Official - Last Name:FOTSO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-385-5743
Mailing Address - Street 1:8604 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-1320
Mailing Address - Country:US
Mailing Address - Phone:301-385-5743
Mailing Address - Fax:
Practice Address - Street 1:8604 BRIARWOOD CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-1320
Practice Address - Country:US
Practice Address - Phone:301-385-5743
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320700000XResidential Treatment FacilitiesResidential Treatment Facility, Physical Disabilities