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General NPI Number Information
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NPI Number | 1356606818
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Entity Type | Organization
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Legal Business Name | 412 RITTENHOUSE ST NW WASHINGTON DC 20011
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 412 RITTENHOUSE ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-1329
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Country | US
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Telephone | 202-384-2143
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Fax |
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Provider Business Mailing Address
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Address Line | 412 RITTENHOUSE ST NW
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City | WASHINGTON
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State | DC
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Zip | 20011-1329
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Country | US
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Telephone | 202-384-2143
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MARIE AHOUEFA HOUEDOU
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Credential | NURSE
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Telephone | 202-384-2143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 281P00000X
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Taxonomy Name | Chronic Disease Hospital
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License Number | 163W00000X
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License Number State | MD
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