Provider Demographics
NPI: | 1457537706 |
---|---|
Name: | FAMILY HEALTH AND BIRTH CENTER, INC |
Entity type: | Organization |
Organization Name: | FAMILY HEALTH AND BIRTH CENTER, INC |
Other - Org Name: | <UNAVAIL> |
Other - Org Type: | |
Authorized Official - Title/Position: | GENERAL DIRECTOR |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | DIANA |
Authorized Official - Middle Name: | RACHEL |
Authorized Official - Last Name: | JOLLES |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | CNM, MS |
Authorized Official - Phone: | 202-398-5520 |
Mailing Address - Street 1: | 801 17TH ST NE |
Mailing Address - Street 2: | |
Mailing Address - City: | WASHINGTON |
Mailing Address - State: | DC |
Mailing Address - Zip Code: | 20002-7200 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 202-398-5520 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 801 17TH ST NE |
Practice Address - Street 2: | |
Practice Address - City: | WASHINGTON |
Practice Address - State: | DC |
Practice Address - Zip Code: | 20002-7200 |
Practice Address - Country: | US |
Practice Address - Phone: | 202-398-5520 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-01-17 |
Last Update Date: | 2008-01-17 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
DC | HFD10-0001 | 261Q00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center |