Healthcare Provider Details

I. General information

NPI: 1245163617
Provider Name (Legal Business Name): OUR COMMUNITY SUPPORT SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5220 N CAPITOL ST NW APT 110
WASHINGTON DC
20011-6764
US

IV. Provider business mailing address

5220 N CAPITOL ST NW APT 110
WASHINGTON DC
20011-6764
US

V. Phone/Fax

Practice location:
  • Phone: 202-855-2929
  • Fax:
Mailing address:
  • Phone: 202-855-2929
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: MS. AVIA MEBANE
Title or Position: CSW
Credential:
Phone: 202-855-2929