Provider Demographics
NPI:1548087877
Name:JOMIAN LLC
Entity type:Organization
Organization Name:JOMIAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHARITY
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUNSANYA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-678-2020
Mailing Address - Street 1:25235 BONNY BROOK LN
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20882-3724
Mailing Address - Country:US
Mailing Address - Phone:240-678-2020
Mailing Address - Fax:
Practice Address - Street 1:25235 BONNY BROOK LN
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20882-3724
Practice Address - Country:US
Practice Address - Phone:240-678-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:JOMIAN LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-09-26
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home