Healthcare Provider Details

I. General information

NPI: 1548430226
Provider Name (Legal Business Name): FEDERAL CITY RECOVERY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2008
Last Update Date: 04/15/2021
Certification Date: 04/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ATLANTIC ST SE
WASHINGTON DC
20032-3040
US

IV. Provider business mailing address

PO BOX 54790
WASHINGTON DC
20032-9390
US

V. Phone/Fax

Practice location:
  • Phone: 202-236-4362
  • Fax:
Mailing address:
  • Phone: 202-236-4362
  • Fax: 202-562-5602

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number102500R007
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. HENRY PRIMES PIERCE III
Title or Position: CEO
Credential:
Phone: 202-236-4362