NPI 1750796876

Mbi

Organisation Physical Disabilities Residential Treatment Facility Washington, DC

Practice location

Address: 115 Missouri Ave NW APT 4, Washington, DC 20011-5241
Phone: (202) 725-9450

Authorised official

Name: Andre Wanteu
Title: Hha
Phone: (202) 725-9450

Registered specialties

Physical Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320700000X Licence HHA9059 (DC)

Other Residential Treatment Facility, Physical Disabilities providers in District of Columbia →

Registry record

NPI: 1750796876
Entity type: Organization
NPI issued: 26 Jun 2014
Record last updated: 26 Jun 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.