Healthcare Provider Details

I. General information

NPI: 1700035508
Provider Name (Legal Business Name): THE PHILLIPMICHAEL COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2008
Last Update Date: 09/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 RIDGE ROAD SUITE 110
WASHINGTON DC
20019
US

IV. Provider business mailing address

6801 TEMPLE HILLS ROAD
TEMPLE HILL MD
20748
US

V. Phone/Fax

Practice location:
  • Phone: 202-306-1723
  • Fax:
Mailing address:
  • Phone: 240-318-2074
  • Fax:

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: LORENZO MICHAEL BROWN
Title or Position: PRESIDENT
Credential:
Phone: 202-306-1723