OrganizationDesire Healthcare LlcNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address9500 Annapolis Rd Ste B5, Lanham, MD 20706-2078(301) 494-4060PECOS EnrollmentBased on the most recent information from CMS, provider Desire Healthcare Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1407447568Provider TypeOrganizationFull NameDesire Healthcare LlcSubpartNoEnumeration Date2/1/2021Last Updated1/7/2022Contact InformationPractice LocationPractice Address9500 Annapolis Rd Ste B5, Lanham, MD 20706-2078Phone(301) 494-4060Fax(301) 494-6667Mailing LocationMailing Address9701 Apollo Dr Ste 100, Largo, MD 20774-4785Phone(301) 494-4060Fax(301) 494-6667Authorized OfficialNameKwi-Mancho, Courage Ntumla (Owner)Phone(240) 505-9321Provider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID115459DescriptionOtherIssuerMEDICAREMaryland