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NPI 1457196412

NPI 1457196412 : UNIVERSAL HEALTH & SERENITY PATHWAYS : WASHINGTON, DC

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General NPI Number Information
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    NPI Number           |    1457196412
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    Entity Type          |    Organization 
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    Legal Business Name  |    UNIVERSAL HEALTH & SERENITY PATHWAYS 
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Dates
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    Enumeration Date     |    07/01/2024
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    Last Update Date     |    11/08/2024
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Provider Practice Location Address
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    Address Line         |    611 DIVISION AVE NE STE 201 
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    City                 |    WASHINGTON
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    State                |    DC
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    Zip                  |    20019-5457
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    Country              |    US
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    Telephone            |    202-204-1361
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    7808 HUBBLE DR 
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    City                 |    LANHAM
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    State                |    MD
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    Zip                  |    20706-2493
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     MELVIS  NDE 
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    Credential           |    
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    Telephone            |    240-640-1512
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261QM1300X
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    Taxonomy Name        |    Multi-Specialty Clinic/Center
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    363LP0808X
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    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
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    License Number       |    
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    License Number State |    
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Taxonomy #3
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    Taxonomy Code        |    261QM0801X
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    Taxonomy Name        |    Mental Health Clinic/Center (Including Community Mental Health Center)
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    License Number       |    
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    License Number State |    
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