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NPI Code Detail

MEDICARE: CHILDRENS HEALTH CENTER AT THEARC CHILDRENS HEALTH PROJECT OF DC

MEDICARE: CHILDRENS HEALTH CENTER AT THEARC CHILDRENS HEALTH PROJECT OF DC
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
1261QC1500XCommunity Health Clinic/CenterHFD01-0208DC

General Provider Information

NPI Number : 1699941815
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDRENS HEALTH CENTER AT THEARC CHILDRENS HEALTH PROJECT OF DC
Provider Business Mailing Address
First Line : 111 MICHIGAN AVE NW
Second Line :
City : WASHINGTON
State : DC
Zip : 20010-2916
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1801 MISSISSIPPI AVE SE
Second Line :
City : WASHINGTON
State : DC
Zip : 20020-6120
Country : US
Telephone Number : 202-436-3060
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR, PAYOR RELATIONS
Name : PHILLICIA NELSON
Credential :
Telephone Number : 301-572-6281
Provider Enumeration Date : 05/07/2008
Last Update Date : 03/31/2023

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