Provider Demographics
NPI:1538942701
Name:CAMPHIRE INIATIVE, LLC.
Entity type:Organization
Organization Name:CAMPHIRE INIATIVE, LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:YETUNDE
Authorized Official - Middle Name:GLADYS
Authorized Official - Last Name:ODOLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-763-2409
Mailing Address - Street 1:1031 RAILBED DR
Mailing Address - Street 2:
Mailing Address - City:ODENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21113-3733
Mailing Address - Country:US
Mailing Address - Phone:202-763-2409
Mailing Address - Fax:
Practice Address - Street 1:1050 CONNECTICUT AVE NW STE 5005
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20036-5303
Practice Address - Country:US
Practice Address - Phone:202-763-2409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-14
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No251B00000XAgenciesCase Management
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251E00000XAgenciesHome Health
No253Z00000XAgenciesIn Home Supportive Care
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No251S00000XAgenciesCommunity/Behavioral Health
No385H00000XRespite Care FacilityRespite Care