Provider Demographics
NPI: | 1306299508 |
---|---|
Name: | ENJL AND ASSOCIATES LLC |
Entity type: | Organization |
Organization Name: | ENJL AND ASSOCIATES LLC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | CHIEF EXECUTIVE OFFICER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | EBONY |
Authorized Official - Middle Name: | N |
Authorized Official - Last Name: | LEA |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 855-325-3909 |
Mailing Address - Street 1: | 840 1ST ST NE FL 3 |
Mailing Address - Street 2: | SUITE 300 |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20002-8000 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 855-325-3909 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 840 1ST ST NE FL 3 |
Practice Address - Street 2: | SUITE 300 |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20002-8000 |
Practice Address - Country: | US |
Practice Address - Phone: | 855-325-3909 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-07-22 |
Last Update Date: | 2017-02-06 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
MD | 16780 | 251S00000X |
DC | LC50080005 | 251S00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 251S00000X | Agencies | Community/Behavioral Health |