Provider Demographics
NPI:1386473387
Name:DAUDASALAMATU COMMUNITY HEALTH SERVICES LLC
Entity type:Organization
Organization Name:DAUDASALAMATU COMMUNITY HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZAINAB
Authorized Official - Middle Name:
Authorized Official - Last Name:MANSARAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-354-6476
Mailing Address - Street 1:5704 HILAND AVE
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706-4700
Mailing Address - Country:US
Mailing Address - Phone:240-354-6476
Mailing Address - Fax:
Practice Address - Street 1:5704 HILAND AVE
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-4700
Practice Address - Country:US
Practice Address - Phone:240-354-6476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DAUSAL HEALTH SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-07-29
Last Update Date:2024-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care