Healthcare Provider Details

I. General information

NPI: 1003168196
Provider Name (Legal Business Name): MARY'S CENTER FOR MATERNAL AND CHILD CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2012
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 TAYLOR ST NW
WASHINGTON DC
20011-5617
US

IV. Provider business mailing address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

V. Phone/Fax

Practice location:
  • Phone: 202-464-9200
  • Fax:
Mailing address:
  • Phone: 202-483-8196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MONIQUE MARGARETA POWELL-DAVIS
Title or Position: CHIEF MEDICAL OFFICER
Credential:
Phone: 202-424-2655