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General NPI Number Information
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NPI Number | 1104095991
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Entity Type | Organization
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Legal Business Name | PEDIATRIC AIDS HIV CARE
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Dates
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Enumeration Date | 02/26/2008
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Last Update Date | 02/26/2008
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Provider Practice Location Address
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Address Line | 450 M ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-4606
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Country | US
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Telephone | 202-347-5366
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Fax | 202-628-3021
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Provider Business Mailing Address
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Address Line | 450 M ST NW
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City | WASHINGTON
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State | DC
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Zip | 20001-4606
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Country | US
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Telephone | 202-347-5366
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Fax | 202-628-3021
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. KHADIJAH A TRIBBLE
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Credential |
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Telephone | 202-347-5366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102X00000X
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Taxonomy Name | Poetry Therapist
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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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 | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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