=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912324096
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FOUNDATION FOR CONTEMPORARY MENTAL HEALTH
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/26/2014
-----------------------------------------------------
Last Update Date | 03/27/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2112 F ST NW SUITE 404
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20037-2715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-296-7100
-----------------------------------------------------
Fax | 202-296-8588
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2112 F ST NW SUITE 404
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20037-2715
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-296-7100
-----------------------------------------------------
Fax | 202-296-8588
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | HOWARD ALAN HOFFMAN
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 202-296-7100
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | MD3578
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------