Provider Demographics
NPI:1902249824
Name:JD NURSING AND MANAGEMENT SERVICES INC
Entity Type:Organization
Organization Name:JD NURSING AND MANAGEMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HHA
Authorized Official - Prefix:MS
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:N
Authorized Official - Last Name:EZEUDU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-281-5657
Mailing Address - Street 1:9716 SPINNAKER ST
Mailing Address - Street 2:
Mailing Address - City:CHELTENHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20623-1354
Mailing Address - Country:US
Mailing Address - Phone:301-281-5657
Mailing Address - Fax:
Practice Address - Street 1:9716 SPINNAKER STREET
Practice Address - Street 2:
Practice Address - City:CHELTENHAM
Practice Address - State:MD
Practice Address - Zip Code:20623-1345
Practice Address - Country:US
Practice Address - Phone:301-281-5657
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JD NURSING AND MANAGEMENT SERVICES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-04-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251J00000X
DC325893409313M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC=========Medicaid