MEDICARE: COMMUNITY FAMILY LIFE SERVICES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency

General Provider Information

NPI Number	:	1184145856
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMMUNITY FAMILY LIFE SERVICES INC

Provider Business Mailing Address
First Line	:	305 E ST NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20001-2711
Country	:	US
Telephone Number	:	202-347-0511
Fax Number	:	202-347-0520

Provider Business Practice Location Address
First Line	:	4860 FORT TOTTEN DR NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20011-7518
Country	:	US
Telephone Number	:	202-635-1745
Fax Number	:	202-635-1626

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ASHLEY MCSWAIN
Credential	:	MSW, MSOD
Telephone Number	:	202-347-0511

Provider Enumeration Date	:	07/03/2017
Last Update Date	:	07/05/2017

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