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General NPI Number Information
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NPI Number | 1114677895
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTHCARE SERVICES, LLC
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Dates
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Enumeration Date | 03/25/2022
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Last Update Date | 08/04/2022
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Provider Practice Location Address
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Address Line | 4261 MEADE ST NE
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City | WASHINGTON
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State | DC
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Zip | 20019-1951
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Country | US
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Telephone | 571-220-9499
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Fax |
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Provider Business Mailing Address
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Address Line | 5820 TILBURY RD
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City | ALEXANDRIA
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State | VA
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Zip | 22310-1607
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Country | US
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Telephone | 571-220-9499
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PAWAN K GUPTA
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Credential |
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Telephone | 571-220-9499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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