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801 17th St Ne Washington DC 20002-7200 | |
| (202) 398-5520 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center |
| Location | 801 17th St Ne, Washington, District Of Columbia |
| Authorized Official Name and Position | Diana Rachel Jolles (GENERAL DIRECTOR) |
| Authorized Official Contact | 2023985520 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 17th St Ne Washington DC 20002-7200 Ph: (202) 398-5520 | 801 17th St Ne Washington DC 20002-7200 Ph: (202) 398-5520 |
| NPI Number | 1457537706 |
|---|---|
| Provider Enumeration Date | 01/17/2008 |
| Last Update Date | 01/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457537706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | HFD10-0001 (District Of Columbia) | Primary |
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