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NPI Code Detail

MEDICARE: GRANTGRAYTON

MEDICARE: GRANTGRAYTON
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1477684637
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANTGRAYTON
Provider Business Mailing Address
First Line : 2412 MINNESOTA AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-5300
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2412 MINNESOTA AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-5300
Country : US
Telephone Number : 202-582-1600
Fax Number : 202-582-1638
Authorized Official
Title or Position : CEO
Name : JAMES GARYTON
Credential :
Telephone Number : 202-582-1600
Provider Enumeration Date : 03/08/2007
Last Update Date : 01/04/2008

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Directions to “GRANTGRAYTON ” Practice Location

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