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General NPI Number Information
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NPI Number | 1427492560
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Entity Type | Organization
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Legal Business Name | THE PEOPLE'S CHOICE BEHAVIORAL & HEALTH CARE CENTER LLC
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Dates
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Enumeration Date | 04/19/2013
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Last Update Date | 04/19/2013
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Provider Practice Location Address
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Address Line | 2918 MINNESOTA AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20019-1127
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Country | US
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Telephone | 202-629-2964
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Fax | 877-735-1149
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Provider Business Mailing Address
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Address Line | 2918 MINNESOTA AVE SE
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City | WASHINGTON
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State | DC
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Zip | 20019-1127
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Country | US
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Telephone | 202-629-2964
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Fax | 877-735-1149
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Authorized Official
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Title or Position | CHIEF CLINICAL DIRECTOR
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Name | DR. OMETHA OONA LEWIS-JACK
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Credential | PHD
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Telephone | 301-275-6615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY1835
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License Number State | DC
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