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General NPI Number Information
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NPI Number | 1861272544
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Entity Type | Organization
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Legal Business Name | THE T.A. COOK AGENCY, LLC
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1535 MORRIS RD SE STE 302
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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 | 202-873-0398
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Fax |
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Provider Business Mailing Address
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Address Line | 712 H ST NE UNIT 669
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City | WASHINGTON
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State | DC
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Zip | 20002-3627
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Country | US
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Telephone | 202-873-0398
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TREVON COOK
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Credential |
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Telephone | 202-873-0398
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 385H00000X
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Taxonomy Name | Respite Care
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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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Taxonomy #3
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Taxonomy Code | 343900000X
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Taxonomy Name | Non-emergency Medical Transport (VAN)
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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