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General NPI Number Information
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NPI Number | 1174818306
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Entity Type | Organization
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Legal Business Name | STAR CENTER ABILITY SERVICES
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Dates
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Enumeration Date | 06/15/2011
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Last Update Date | 06/15/2011
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Provider Practice Location Address
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Address Line | 5416 13TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-3610
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Country | US
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Telephone | 202-288-1867
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Fax | 703-997-0425
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Provider Business Mailing Address
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Address Line | 5416 13TH ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-3610
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Country | US
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Telephone | 202-288-1867
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Fax | 703-997-0425
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Authorized Official
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Title or Position | PRINCIPAL
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Name | MR. G. KEITH JARRELL
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Credential |
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Telephone | 202-600-5417
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State |
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