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General NPI Number Information
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NPI Number | 1013683762
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Entity Type | Organization
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Legal Business Name | BREAD FOR THE CITY INC
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Dates
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Enumeration Date | 08/20/2021
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Last Update Date | 12/28/2021
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Provider Practice Location Address
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Address Line | 1700 GOOD HOPE ROAD SE
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City | WASHINGTON
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State | DC
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Zip | 20020
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Country | US
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Telephone | 202-386-7020
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Fax | 202-265-1970
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Provider Business Mailing Address
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Address Line | 1525 7TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-3201
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Country | US
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Telephone | 202-265-2400
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Fax | 202-265-1050
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | RANDI CAROL ABRAMSON
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Credential | MD
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Telephone | 202-265-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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