Provider Demographics
NPI:1043951072
Name:BUDGATE HOME HEALTHE CARE LLC
Entity type:Organization
Organization Name:BUDGATE HOME HEALTHE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MISS
Authorized Official - First Name:ROZA
Authorized Official - Middle Name:MOHAMMED
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:571-835-3447
Mailing Address - Street 1:PO BOX 2413
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20915
Mailing Address - Country:US
Mailing Address - Phone:571-835-3447
Mailing Address - Fax:
Practice Address - Street 1:2502 RANDOLPH RD
Practice Address - Street 2:2502
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-1238
Practice Address - Country:US
Practice Address - Phone:571-835-3447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDW22539414Medicaid