DataLabs
datalabs.health made in the usa
DataLabs Facebook Wall   Like   Follow DataLabs on Twitter   Tweet  
Contact us Sign in |  Documentation | 
NPI Code Detail

MEDICARE: GREEN DOOR, INC.

MEDICARE: GREEN DOOR, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianMD33367DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
123653OTHERDCCHARTERED HEALTH PLAN
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1073659140
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREEN DOOR, INC.
Provider Business Mailing Address
First Line : 1221 TAYLOR ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-5617
Country : US
Telephone Number : 202-464-9200
Fax Number : 202-464-5740
Provider Business Practice Location Address
First Line : 1221 TAYLOR ST NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20011-5617
Country : US
Telephone Number : 202-464-9200
Fax Number : 202-464-5740
Authorized Official
Title or Position : DEPUTY DIRECTOR
Name : MR. MICHAEL CLANCY
Credential :
Telephone Number : 202-464-9200
Provider Enumeration Date : 01/29/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1245180892 — EMMANUEL ADEKUNLE
Practice Location Address:
1221 TAYLOR ST NW
WASHINGTON, DC
20011-5617
Practice Phone: 202-464-9200
Practice Fax:
1639918998 — ACHA NKEMASONG NKENGANYI
Practice Location Address:
1221 TAYLOR ST NW
WASHINGTON, DC
20011-5617
Practice Phone: 202-464-9200
Practice Fax:
1760998959 — LINDALINE ENOWMBI NCHO
Practice Location Address:
1221 TAYLOR ST NW
WASHINGTON, DC
20011-5617
Practice Phone: 202-464-9200
Practice Fax:
1124102488 — DR. LINDA GERARDINE MCCULLOUGH PH.D., LPC
Practice Location Address:
1221 TAYLOR ST NW
WASHINGTON, DC
20011-5617
Practice Phone: 202-464-9200
Practice Fax: 202-464-5730
1891841391 — GREEN DOOR, INC.
Practice Location Address:
1221 TAYLOR ST NW
WASHINGTON, DC
20011-5617
Practice Phone: 202-464-9200
Practice Fax: 202-464-5730
1982740056 — GREEN DOOR, INC
Practice Location Address:
1221 TAYLOR ST NW
WASHINGTON, DC
20011-5617
Practice Phone: 202-464-9200
Practice Fax:

Directions to “GREEN DOOR, INC. ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.