Healthcare Provider Details

I. General information

NPI: 1679217244
Provider Name (Legal Business Name): MARYS CENTER FOR MATERNAL AND CHILD CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2022
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8908 RIGGS RD
ADELPHI MD
20783-1632
US

IV. Provider business mailing address

2333 ONTARIO RD NW
WASHINGTON DC
20009-2627
US

V. Phone/Fax

Practice location:
  • Phone: 844-796-2797
  • Fax: 301-422-5935
Mailing address:
  • Phone: 202-483-8196
  • Fax: 202-483-0302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL

VIII. Authorized Official

Name: NANCY BAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 202-483-8196