Basic Information
| Provider Information | |||||||||
| NPI: | 1649530486 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | OFE | ||||||||
| FirstName: | VERNON | ||||||||
| MiddleName: | ABIA AKU | ||||||||
| NamePrefix: | MR. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6114 BREEZEWOOD DR APT 202 | ||||||||
| Address2: | |||||||||
| City: | GREENBELT | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207704143 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 6856 EASTERN AVE NW STE 350 | ||||||||
| Address2: | |||||||||
| City: | WASHINGTON | ||||||||
| State: | DC | ||||||||
| PostalCode: | 200122166 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2025450211 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2012 | ||||||||
| LastUpdateDate: | 02/11/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 320700000X | N | Residential Treatment Facilities | Residential Treatment Facility, Physical Disabilities | 374U00000X | Y | Nursing Service Related Providers | Home Health Aide |
No ID Information.