Provider Demographics
| NPI: | 1669192365 |
|---|---|
| Name: | CARPENTERS SERVICES |
| Entity type: | Organization |
| Organization Name: | CARPENTERS SERVICES |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CEO |
| Authorized Official - Prefix: | MRS |
| Authorized Official - First Name: | JACKIE |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | CARPENTER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | MD |
| Authorized Official - Phone: | 202-290-9838 |
| Mailing Address - Street 1: | 4639 HILLTOP TER SE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WASHINGTON |
| Mailing Address - State: | DC |
| Mailing Address - Zip Code: | 20019-7837 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 202-290-9838 |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 4639 HILLTOP TER SE |
| Practice Address - Street 2: | |
| Practice Address - City: | WASHINGTON |
| Practice Address - State: | DC |
| Practice Address - Zip Code: | 20019-7837 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 202-290-9838 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2022-09-01 |
| Last Update Date: | 2022-09-01 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QC1500X | Ambulatory Health Care Facilities | Clinic/Center | Community Health | Group - Multi-Specialty |
| No | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
| No | 207VC0200X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Critical Care Medicine | Group - Multi-Specialty |
| No | 208200000X | Allopathic & Osteopathic Physicians | Plastic Surgery | Group - Multi-Specialty | |
| No | 251S00000X | Agencies | Community/Behavioral Health | ||
| No | 253Z00000X | Agencies | In Home Supportive Care | ||
| No | 261QC1800X | Ambulatory Health Care Facilities | Clinic/Center | Corporate Health | |
| No | 261QE0002X | Ambulatory Health Care Facilities | Clinic/Center | Emergency Care | |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | |
| No | 261QR0800X | Ambulatory Health Care Facilities | Clinic/Center | Recovery Care | |
| No | 261QU0200X | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care | |
| No | 305S00000X | Managed Care Organizations | Point of Service | ||
| No | 320900000X | Residential Treatment Facilities | Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities | ||
| No | 333300000X | Suppliers | Emergency Response System Companies | ||
| No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | Group - Multi-Specialty |
