Provider Demographics
NPI:1396097408
Name:ST. JOSEPH HEALTHCARE LLC
Entity type:Organization
Organization Name:ST. JOSEPH HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHANTAL
Authorized Official - Middle Name:BIH
Authorized Official - Last Name:ADEMBUH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-593-1547
Mailing Address - Street 1:6210 N CAPITOL ST NW
Mailing Address - Street 2:NW
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1416
Mailing Address - Country:US
Mailing Address - Phone:240-593-1547
Mailing Address - Fax:240-294-7966
Practice Address - Street 1:6210 N CAPITOL ST NW
Practice Address - Street 2:NW
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1416
Practice Address - Country:US
Practice Address - Phone:240-593-1547
Practice Address - Fax:240-294-7966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-12
Last Update Date:2012-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health