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General NPI Number Information
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NPI Number | 1154574341
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Entity Type | Organization
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Legal Business Name | SASHA BRUCE YOUTHWORK, INC.
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Dates
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Enumeration Date | 10/31/2008
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Last Update Date | 10/31/2008
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Provider Practice Location Address
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Address Line | 741 8TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-2802
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Country | US
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Telephone | 202-675-9340
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Fax | 202-675-9358
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Provider Business Mailing Address
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Address Line | 741 8TH ST SE
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City | WASHINGTON
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State | DC
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Zip | 20003-2802
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Country | US
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Telephone | 202-675-9340
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Fax | 202-675-9358
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MS. DEBORAH SHORE
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Credential |
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Telephone | 202-675-9340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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License Number |
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License Number State | DC
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