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General NPI Number Information
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NPI Number | 1265465876
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Entity Type | Organization
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Legal Business Name | UNIVERSAL HEALTHCARE
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Dates
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Enumeration Date | 07/08/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 3230 PENNSYLVANIA AVE SE SUITE 213
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City | WASHINGTON
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State | DC
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Zip | 20020-3722
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Country | US
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Telephone | 202-583-1181
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Fax | 202-583-1186
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Provider Business Mailing Address
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Address Line | 3230 PENNSYLVANIA AVE SE SUITE 213
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City | WASHINGTON
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State | DC
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Zip | 20020-3722
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Country | US
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Telephone | 202-583-1181
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Fax | 202-583-1186
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. MICHELLE VANESSA LEWIS
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Credential | LICSW, ACSW, CAS
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Telephone | 202-583-1181
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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 | 45678932189099999999
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License Number State | DC
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