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General NPI Number Information
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NPI Number | 1528833688
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Entity Type | Organization
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Legal Business Name | MEMM'S HOLISTIC HEALTH AND COMMUNITY SERVICES
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Dates
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Enumeration Date | 11/20/2023
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Last Update Date | 11/20/2023
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Provider Practice Location Address
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Address Line | 323 15TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20002-6501
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Country | US
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Telephone | 240-487-8992
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Fax |
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Provider Business Mailing Address
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Address Line | 5730 BLAIR RD NW
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City | WASHINGTON
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State | DC
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Zip | 20011-2360
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Country | US
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Telephone | 240-487-8992
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MODESTINE DJAMO
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Credential | RN
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Telephone | 240-487-8992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD1600X
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Taxonomy Name | Developmental Disabilities Clinic/Center
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License Number |
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License Number State |
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