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General NPI Number Information
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NPI Number | 1538405675
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Entity Type | Organization
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Legal Business Name | DEPARTMENT OF MENTAL HEALTH - SAINT ELIZABETHS HOSPITAL
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Dates
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Enumeration Date | 12/18/2012
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Last Update Date | 12/18/2012
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Provider Practice Location Address
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Address Line | 1100 ALABAMA AVE SE CASHIERS OFFICE
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City | WASHINGTON
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State | DC
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Zip | 20032-4540
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Country | US
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Telephone | 202-299-5500
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 ALABAMA AVE SE CASHIERS OFFICE
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City | WASHINGTON
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State | DC
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Zip | 20032-4540
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Country | US
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Telephone | 202-299-5500
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Fax |
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Authorized Official
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Title or Position | BUDGET DIRECTOR
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Name | JAMES JACKSON
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Credential |
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Telephone | 202-288-0754
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number | HFD01-0230
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License Number State | DC
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