Healthcare Provider Details

I. General information

NPI: 1023912581
Provider Name (Legal Business Name): MR. VINCENT JONES
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 MARTIN LUTHER KING JR AVE SE
WASHINGTON DC
20020-7024
US

IV. Provider business mailing address

2000 S ANVIL LN
TEMPLE HILLS MD
20748-4282
US

V. Phone/Fax

Practice location:
  • Phone: 877-659-4500
  • Fax:
Mailing address:
  • Phone: 877-649-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: