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General NPI Number Information
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NPI Number | 1669033106
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Entity Type | Organization
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Legal Business Name | PREVENTIVE MEASURE OF WASHINGTON DC, LLC
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Dates
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Enumeration Date | 06/25/2019
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Last Update Date | 06/25/2019
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Provider Practice Location Address
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Address Line | 7826 EASTERN AVE NW STE 201
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City | WASHINGTON
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State | DC
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Zip | 20012-1333
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Country | US
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Telephone | 202-849-8798
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Fax | 202-478-2823
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Provider Business Mailing Address
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Address Line | 2759 MARTIN LUTHER KING JR AVE SE STE B7
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City | WASHINGTON
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State | DC
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Zip | 20032-2648
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Country | US
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Telephone | 202-563-7632
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | CHERYL MICHELE JONES
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Credential |
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Telephone | 202-510-2019
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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