Healthcare Provider Details

I. General information

NPI: 1356694277
Provider Name (Legal Business Name): ONE WORLD FOUNDATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 BALSAMTREE DR
CAPITOL HEIGHTS MD
20743-1427
US

IV. Provider business mailing address

807 BALSAMTREE DR
CAPITOL HEIGHTS MD
20743-1427
US

V. Phone/Fax

Practice location:
  • Phone: 301-541-0523
  • Fax:
Mailing address:
  • Phone: 301-541-0523
  • Fax: 240-560-7541

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code3245S0500X
TaxonomyChildren's Substance Abuse Rehabilitation Facility
License Number904905
License Number StateMD

VIII. Authorized Official

Name: MR. PATRICK GASSION
Title or Position: PRESIDENT/CEO
Credential:
Phone: 301-300-7506