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General NPI Number Information
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NPI Number | 1982202271
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Entity Type | Organization
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Legal Business Name | BERKELEY HOUSE INC.
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Dates
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Enumeration Date | 10/09/2020
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Last Update Date | 11/13/2020
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Provider Practice Location Address
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Address Line | 817 ELDER ST NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2323
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Country | US
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Telephone | 240-305-2723
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Fax |
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Provider Business Mailing Address
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Address Line | 817 ELDER ST NW
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City | WASHINGTON
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State | DC
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Zip | 20012-2323
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Country | US
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Telephone | 240-305-2723
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANKLIN HEKIMA JACKSON
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Credential | MBA, DDA CERT-MARYLA
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Telephone | 240-305-2723
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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