NPI Code Details Logo

NPI 1194077297

NPI 1194077297 : MARY'S CENTER FOR MATERNAL AND CHILD CARE, INC. : HYATTSVILLE, MD

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1194077297
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    MARY'S CENTER FOR MATERNAL AND CHILD CARE, INC. 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    10/12/2012
-----------------------------------------------------
    Last Update Date     |    09/29/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    8908 RIGGS RD 
-----------------------------------------------------
    City                 |    HYATTSVILLE
-----------------------------------------------------
    State                |    MD
-----------------------------------------------------
    Zip                  |    20783-1632
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    202-483-8196
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    2333 ONTARIO RD NW 
-----------------------------------------------------
    City                 |    WASHINGTON
-----------------------------------------------------
    State                |    DC
-----------------------------------------------------
    Zip                  |    20009-2627
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    202-483-8196
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    CHIEF MEDICAL OFFICER
-----------------------------------------------------
    Name                 |     MONIQUE MARGARETA POWELL-DAVIS 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    202-424-2655
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    261QD0000X
-----------------------------------------------------
    Taxonomy Name        |    Dental Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QM0801X
-----------------------------------------------------
    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
    Taxonomy Code        |    261QF0400X
-----------------------------------------------------
    Taxonomy Name        |    Federally Qualified Health Center (FQHC)
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.