Provider Demographics
NPI:1033757232
Name:DISTRICT OF COLUMBIA RECOVERY COMMUNITY ALLIANCE INC
Entity Type:Organization
Organization Name:DISTRICT OF COLUMBIA RECOVERY COMMUNITY ALLIANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:NATHANIEL
Authorized Official - Last Name:TYLER
Authorized Official - Suffix:SR
Authorized Official - Credentials:
Authorized Official - Phone:202-776-0645
Mailing Address - Street 1:5656A 3RD ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-2532
Mailing Address - Country:US
Mailing Address - Phone:202-776-0645
Mailing Address - Fax:
Practice Address - Street 1:5656A 3RD ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-2532
Practice Address - Country:US
Practice Address - Phone:202-776-0645
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-18
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health