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General NPI Number Information
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NPI Number | 1568595171
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Entity Type | Organization
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Legal Business Name | INTEGRATED BEHAVIOR SERVICES GROUP INC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 07/10/2018
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Provider Practice Location Address
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Address Line | 3200 S ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020
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Country | US
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Telephone | 202-610-1444
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Fax | 202-610-1445
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Provider Business Mailing Address
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Address Line | 3200 S ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-2410
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Country | US
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Telephone | 202-610-1444
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Fax | 202-610-1445
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Authorized Official
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Title or Position | CEO
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Name | MS. MARY J SAMBA
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Credential |
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Telephone | 202-610-0144
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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 | 036003900
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License Number State | DC
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