| Eclectic Dc | |
|
3818 25th Pl Ne Washington DC 20018-3121 | |
| (202) 681-3820 | |
| Not Available |
| Full Name | Eclectic Dc |
|---|---|
| Speciality | Social Worker |
| Location | 3818 25th Pl Ne, Washington, District Of Columbia |
| Authorized Official Name and Position | Christian Greene (OWNER) |
| Authorized Official Contact | 2026813820 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Eclectic Dc 3818 25th Pl Ne Washington DC 20018-3121 Ph: (202) 681-3820 | Eclectic Dc 3818 25th Pl Ne Washington DC 20018-3121 Ph: (202) 681-3820 |
| NPI Number | 1144991902 |
|---|---|
| Provider Enumeration Date | 09/22/2021 |
| Last Update Date | 09/22/2021 |
| Certification Date | 09/22/2021 |
| Medicare PECOS PAC ID | 1355739269 |
|---|---|
| Medicare Enrollment ID | O20211026002880 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144991902 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Christian Greene |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215084751 PECOS PAC ID: 9335537240 Enrollment ID: I20211026003042 |
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