Healthcare Provider Details

I. General information

NPI: 1770838674
Provider Name (Legal Business Name): THE FOUNDATION FOR CONTEMPORARY MENTAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2012
Last Update Date: 07/17/2012
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

Practice location:
  • Phone: 202-296-7100
  • Fax: 202-296-8588
Mailing address:
  • Phone: 202-296-7100
  • Fax: 202-296-8588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number102600A-031
License Number StateDC

VIII. Authorized Official

Name: MS. AUDREY F. CANNAMELA
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 202-349-3217