Healthcare Provider Details

I. General information

NPI: 1912643321
Provider Name (Legal Business Name): UNICORN HEALTH CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2022
Last Update Date: 05/09/2022
Certification Date: 05/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 PENNSYLVANIA AVE SE STE 410
WASHINGTON DC
20003-4339
US

IV. Provider business mailing address

650 PENNSYLVANIA AVE SE STE 410
WASHINGTON DC
20003-4339
US

V. Phone/Fax

Practice location:
  • Phone: 703-517-1947
  • Fax: 202-544-3004
Mailing address:
  • Phone: 703-517-1947
  • Fax: 202-544-3004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM RICE III
Title or Position: BUSINESS SYSTEMS MANAGER
Credential:
Phone: 202-674-1227