Provider Demographics
NPI:1720828064
Name:A EPIPHANY HOME HEALTH CARE LLC
Entity type:Organization
Organization Name:A EPIPHANY HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELISE
Authorized Official - Middle Name:EMILIE QUINTA
Authorized Official - Last Name:MBAYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-469-3142
Mailing Address - Street 1:173 OGUNQUIT DR
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1826
Mailing Address - Country:US
Mailing Address - Phone:571-469-3142
Mailing Address - Fax:
Practice Address - Street 1:173 OGUNQUIT DR
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1826
Practice Address - Country:US
Practice Address - Phone:571-469-3142
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care