Provider Demographics
NPI:1770071664
Name:HOPELINK HEALTHCARE SERVICES
Entity type:Organization
Organization Name:HOPELINK HEALTHCARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:BAGUIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:BAYALA
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:240-481-9368
Mailing Address - Street 1:3511 WOODLAKE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-4671
Mailing Address - Country:US
Mailing Address - Phone:240-505-9041
Mailing Address - Fax:
Practice Address - Street 1:3511 WOODLAKE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-4671
Practice Address - Country:US
Practice Address - Phone:240-505-9041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-25
Last Update Date:2018-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR14103251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD462315265Medicaid