Provider Demographics
NPI:1962974733
Name:AMAZING GROUP
Entity type:Organization
Organization Name:AMAZING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-615-6162
Mailing Address - Street 1:3302 THEODORE R HAGANS DR NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-4320
Mailing Address - Country:US
Mailing Address - Phone:202-615-6162
Mailing Address - Fax:
Practice Address - Street 1:3302 THEODORE R HAGANS DR NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-4320
Practice Address - Country:US
Practice Address - Phone:202-615-6162
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-18
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services