Healthcare Provider Details

I. General information

NPI: 1316148554
Provider Name (Legal Business Name): THE FOUNDATION FOR CONTEMPORARY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 07/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2112 F ST NW SUITE 102
WASHINGTON DC
20037-2715
US

IV. Provider business mailing address

2112 F ST NW STE 102
WASHINGTON DC
20037-2722
US

V. Phone/Fax

Practice location:
  • Phone: 202-296-4422
  • Fax: 202-822-9130
Mailing address:
  • Phone: 202-296-4422
  • Fax: 202-822-9130

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. AUDREY CANNAMELA
Title or Position: CEO
Credential:
Phone: 202-349-3218