Healthcare Provider Details
I. General information
NPI: 1346427630
Provider Name (Legal Business Name): NEIGHBORS CONSEJO
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3118 16TH ST NW
WASHINGTON DC
20010-3301
US
IV. Provider business mailing address
3118 16TH ST NW
WASHINGTON DC
20010-3301
US
V. Phone/Fax
- Phone: 202-234-6855
- Fax: 202-234-4863
- Phone: 202-234-6855
- Fax: 202-234-4863
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 324500000X |
| Taxonomy | Substance Abuse Rehabilitation Facility |
| License Number | |
| License Number State | DC |
VIII. Authorized Official
Name: MRS.
RUTH
TILLETT
Title or Position: INTERIM CEO
Credential:
Phone: 202-234-6855