Provider Demographics
NPI:1548050107
Name:IZYHEALTHCARE, LLC
Entity type:Organization
Organization Name:IZYHEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:IZEKU
Authorized Official - Middle Name:IZIEGBE
Authorized Official - Last Name:EKATAH
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:240-813-0304
Mailing Address - Street 1:12774 WISTERIA DR # 353
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-9998
Mailing Address - Country:US
Mailing Address - Phone:240-813-0304
Mailing Address - Fax:641-206-7158
Practice Address - Street 1:12774 WISTERIA DR # 353
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-9998
Practice Address - Country:US
Practice Address - Phone:240-813-0304
Practice Address - Fax:641-206-7158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-07
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management
No251J00000XAgenciesNursing Care
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health