Provider Demographics
NPI:1427835024
Name:JUDICIOUS HEALTHCARE
Entity type:Organization
Organization Name:JUDICIOUS HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NOELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:MASALLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-898-8033
Mailing Address - Street 1:11201 HOMESTEAD DR
Mailing Address - Street 2:
Mailing Address - City:UPPER MARLBORO
Mailing Address - State:MD
Mailing Address - Zip Code:20774-5761
Mailing Address - Country:US
Mailing Address - Phone:240-898-8033
Mailing Address - Fax:
Practice Address - Street 1:11201 HOMESTEAD DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-5761
Practice Address - Country:US
Practice Address - Phone:240-898-8033
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-08
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities