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General NPI Number Information
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NPI Number | 1093306185
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Entity Type | Organization
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Legal Business Name | 1441, INC
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Dates
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Enumeration Date | 02/01/2021
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 3904 BYERS ST
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-5720
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Country | US
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Telephone | 202-597-7722
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Fax |
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Provider Business Mailing Address
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Address Line | 3904 BYERS ST
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City | CAPITOL HEIGHTS
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State | MD
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Zip | 20743-5720
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Country | US
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Telephone | 202-597-7722
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Fax | 202-403-3512
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Authorized Official
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Title or Position | OFFICE MANGER
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Name | DONYA BUTLER
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Credential | CCMA, CPT, CMT
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Telephone | 240-486-7284
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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