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General NPI Number Information
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NPI Number | 1821584921
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Entity Type | Organization
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Legal Business Name | MARYS CENTER FOR MATERNAL AND CHILD CARE INC
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Dates
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Enumeration Date | 07/02/2018
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 4302 GEORGIA AVE NW
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City | WASHINGTON
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State | DC
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Zip | 20011-7122
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Country | US
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Telephone | 202-483-8196
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Fax |
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Provider Business Mailing Address
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Address Line | 2333 ONTARIO RD NW
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City | WASHINGTON
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State | DC
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Zip | 20009-2627
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Country | US
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Telephone | 202-483-8196
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Fax | 202-545-2076
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | MONIQUE MARGARETA POWELL-DAVIS
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Credential |
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Telephone | 202-424-2655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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Taxonomy #2
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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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