Healthcare Provider Details

I. General information

NPI: 1003277351
Provider Name (Legal Business Name): BREATHE DC, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/15/2016
Last Update Date: 03/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SOUTHERN AVE SE SUITE G-082
WASHINGTON DC
20032-4623
US

IV. Provider business mailing address

1310 SOUTHERN AVE SE SUITE G-082
WASHINGTON DC
20032-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-574-6789
  • Fax:
Mailing address:
  • Phone: 202-574-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number400212000180
License Number StateDC

VIII. Authorized Official

Name: MR. ROLANDO A ANDREWN
Title or Position: PRESIDENT & CEO
Credential:
Phone: 202-574-6024