Healthcare Provider Details
I. General information
NPI: 1912324096
Provider Name (Legal Business Name): FOUNDATION FOR CONTEMPORARY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/26/2014
Last Update Date: 03/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2112 F ST NW SUITE 404
WASHINGTON DC
20037-2715
US
IV. Provider business mailing address
2112 F ST NW SUITE 404
WASHINGTON DC
20037-2715
US
V. Phone/Fax
- Phone: 202-296-7100
- Fax: 202-296-8588
- Phone: 202-296-7100
- Fax: 202-296-8588
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MD3578 |
| License Number State | DC |
VIII. Authorized Official
Name:
HOWARD
ALAN
HOFFMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 202-296-7100