MEDICARE: LATITUDE HEALTH SERVICES.COM

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	251S00000X	Community/Behavioral Health Agency		DC

General Provider Information

NPI Number	:	1346613023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LATITUDE HEALTH SERVICES.COM

Provider Business Mailing Address
First Line	:	412 H ST NE
Second Line	:	NE SUITE100
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4336
Country	:	US
Telephone Number	:	240-487-9033
Fax Number	:

Provider Business Practice Location Address
First Line	:	412 H ST NE
Second Line	:	NE SUITE100
City	:	WASHINGTON
State	:	DC
Zip	:	20002-4336
Country	:	US
Telephone Number	:	240-487-9033
Fax Number	:

Authorized Official
Title or Position	:	OWNER/CEO
Name	:	MS. TERRIA MASTERSON
Credential	:
Telephone Number	:	240-487-9033

Provider Enumeration Date	:	11/03/2015
Last Update Date	:	11/03/2015

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Directions to “LATITUDE HEALTH SERVICES.COM ” Practice Location

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