=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982504510
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | STREETS AND CO CULINARY GROUP
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/07/2026
-----------------------------------------------------
Last Update Date | 11/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 15480 ANNAPOLIS RD
-----------------------------------------------------
City | BOWIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20715-1852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-422-1850
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 15480 ANNAPOLIS RD
-----------------------------------------------------
City | BOWIE
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20715-1852
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-422-1850
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ALEXIS STREETS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 202-422-1850
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174200000X
-----------------------------------------------------
Taxonomy Name | Meals Provider
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------