Provider Demographics
NPI:1992320188
Name:LABRADOR HEALTH INC
Entity type:Organization
Organization Name:LABRADOR HEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:ELLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-461-9407
Mailing Address - Street 1:6915 RIDGEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815-5149
Mailing Address - Country:US
Mailing Address - Phone:301-461-9407
Mailing Address - Fax:
Practice Address - Street 1:6915 RIDGEWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-5149
Practice Address - Country:US
Practice Address - Phone:301-461-9407
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management