MEDICARE: ARIEL ALLIANCE

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
1	251C00000X	Developmentally Disabled Services Day Training Agency		DC

General Provider Information

NPI Number	:	1548498769
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARIEL ALLIANCE

Provider Business Mailing Address
First Line	:	245 OGLETHORPE ST NW APT 3
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-2222
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	245 OGLETHORPE ST NW APT 3
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-2222
Country	:	US
Telephone Number	:	202-652-0577
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. LEE MOORE
Credential	:	M.ED
Telephone Number	:	202-652-0577

Provider Enumeration Date	:	06/25/2009
Last Update Date	:	06/25/2009

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