Healthcare Provider Details

I. General information

NPI: 1518792993
Provider Name (Legal Business Name): WASHINGTON DC HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/04/2024
Last Update Date: 09/04/2024
Certification Date: 09/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4523 ALABAMA AVE SE
WASHINGTON DC
20019-4912
US

IV. Provider business mailing address

4523 ALABAMA AVE SE
WASHINGTON DC
20019-4912
US

V. Phone/Fax

Practice location:
  • Phone: 202-255-2574
  • Fax:
Mailing address:
  • Phone: 202-255-2574
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD1600X
TaxonomyDevelopmental Disabilities Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: AGNES MASSAWE
Title or Position: CEO
Credential:
Phone: 202-255-2574