Healthcare Provider Details

I. General information

NPI: 1376162040
Provider Name (Legal Business Name): UNITY HEALTH CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2020
Last Update Date: 04/28/2020
Certification Date: 04/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 NEW YORK AVE NE
WASHINGTON DC
20002-1725
US

IV. Provider business mailing address

1100 NEW JERSEY AVE SE STE 500
WASHINGTON DC
20003-3326
US

V. Phone/Fax

Practice location:
  • Phone: 202-715-7900
  • Fax: 202-544-3783
Mailing address:
  • Phone: 202-715-7900
  • Fax: 202-544-3783

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JAY WILLIAMS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 202-715-7900