Healthcare Provider Details

I. General information

NPI: 1083951487
Provider Name (Legal Business Name): HOMES FOR HOPE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2013
Last Update Date: 07/10/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 G ST SE APT A
WASHINGTON DC
20019-1122
US

IV. Provider business mailing address

3003 G ST SE APT A
WASHINGTON DC
20019-1122
US

V. Phone/Fax

Practice location:
  • Phone: 202-582-1970
  • Fax: 202-582-0522
Mailing address:
  • Phone: 202-582-1970
  • Fax: 202-582-0522

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VERONICA JENKINS
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D.
Phone: 202-582-1970