Healthcare Provider Details

I. General information

NPI: 1548460942
Provider Name (Legal Business Name): SHERIDAN REHABILITATIVE AND WELLNESS CENTERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/23/2007
Last Update Date: 07/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 SHERIDAN ST NW
WASHINGTON DC
20011-1128
US

IV. Provider business mailing address

919 SHERIDAN ST NW
WASHINGTON DC
20011-1128
US

V. Phone/Fax

Practice location:
  • Phone: 202-248-6107
  • Fax: 202-315-3540
Mailing address:
  • Phone: 202-248-6107
  • Fax: 202-315-3540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. J L WHEELER
Title or Position: CEO
Credential: MD
Phone: 202-248-6107