MEDICARE: CONNECTING WITH COMMUNITIES

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	261QD1600X	Developmental Disabilities Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1340992	OTHER	DC	NATIONAL ACADEMY OF SPORTS MEDICINE

General Provider Information

NPI Number	:	1205496270
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CONNECTING WITH COMMUNITIES

Provider Business Mailing Address
First Line	:	6308 SANTO PL
Second Line	:
City	:	CAPITOL HEIGHTS
State	:	MD
Zip	:	20743-3258
Country	:	US
Telephone Number	:	757-235-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	2636 WADE RD SE APT 11
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20020-5906
Country	:	US
Telephone Number	:	757-235-1030
Fax Number	:

Authorized Official
Title or Position	:	CLINICAL DIRECTOR
Name	:	MRS. BUFFIE FINLEY
Credential	:
Telephone Number	:	757-235-1030

Provider Enumeration Date	:	06/20/2019
Last Update Date	:	06/20/2019

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Directions to “CONNECTING WITH COMMUNITIES ” Practice Location

Language	Start Address	Practice Location

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