MEDICARE: AMERICAN HEALTH CARE 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295969939
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN HEALTH CARE SERVICES INC

Provider Business Mailing Address
First Line	:	4427 7TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-2208
Country	:	US
Telephone Number	:	202-529-3309
Fax Number	:	202-379-1747

Provider Business Practice Location Address
First Line	:	4427 7TH ST NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20017-2208
Country	:	US
Telephone Number	:	202-529-3309
Fax Number	:	202-379-1747

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JAMES ODIMEGWU
Credential	:
Telephone Number	:	202-529-3309

Provider Enumeration Date	:	05/10/2009
Last Update Date	:	05/10/2009

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