Provider Demographics
NPI:1912337106
Name:BILOS MEGA CARE
Entity type:Organization
Organization Name:BILOS MEGA CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HEALTH AID
Authorized Official - Prefix:MR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:
Authorized Official - Last Name:NDIBANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-560-1352
Mailing Address - Street 1:6475 NEW HAMPSHIRE AVE STE B504F
Mailing Address - Street 2:
Mailing Address - City:HYATTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20783-3269
Mailing Address - Country:US
Mailing Address - Phone:301-560-1352
Mailing Address - Fax:
Practice Address - Street 1:6475 NEW HAMPSHIRE AVE STE B504F
Practice Address - Street 2:
Practice Address - City:HYATTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20783-3269
Practice Address - Country:US
Practice Address - Phone:301-560-1352
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BIOS MEGA CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-11-25
Last Update Date:2013-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
144784311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home