Provider Demographics
NPI:1699950311
Name:BREAD FOR THE CITY,INC.
Entity type:Organization
Organization Name:BREAD FOR THE CITY,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDI
Authorized Official - Middle Name:
Authorized Official - Last Name:ABRAMSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-386-7020
Mailing Address - Street 1:1525 7TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3201
Mailing Address - Country:US
Mailing Address - Phone:202-265-2400
Mailing Address - Fax:202-265-1970
Practice Address - Street 1:1525 7TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-3201
Practice Address - Country:US
Practice Address - Phone:202-265-2400
Practice Address - Fax:202-265-1970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-31
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 261QF0400X, 261QM0801X
DCDEN1001056261QD0000X
DC52113XXXX-41005687261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No251B00000XAgenciesCase Management
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)