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General NPI Number Information
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NPI Number | 1518427970
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Entity Type | Organization
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Legal Business Name | PATRONS HEALTHCARE SERVICES
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 03/21/2019
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Provider Practice Location Address
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Address Line | 7826 EASTERN AVE NW STE 412D
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City | WASHINGTON
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State | DC
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Zip | 20012-1324
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Country | US
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Telephone | 202-350-1697
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Fax |
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Provider Business Mailing Address
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Address Line | 4603 LOGSDON DR
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City | ANNANDALE
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State | VA
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Zip | 22003-3527
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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 | CEO
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Name | SUSAN JIOFACK
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Credential |
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Telephone | 202-350-1697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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