Provider Demographics
NPI:1285185926
Name:DAYSPRING HEALTHCARE INC
Entity type:Organization
Organization Name:DAYSPRING HEALTHCARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:AYODEJI
Authorized Official - Middle Name:OLALEKAN
Authorized Official - Last Name:ODUSANYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-691-2195
Mailing Address - Street 1:1940 DUKE ST FL 2
Mailing Address - Street 2:ROOM 256
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22314-3451
Mailing Address - Country:US
Mailing Address - Phone:240-691-2195
Mailing Address - Fax:
Practice Address - Street 1:1940 DUKE ST FL 2
Practice Address - Street 2:ROOM 256
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22314-3451
Practice Address - Country:US
Practice Address - Phone:240-691-2195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health