Provider Demographics
NPI:1063820876
Name:PENDERGRAST ALSTON CONSULTING SERVICES
Entity Type:Organization
Organization Name:PENDERGRAST ALSTON CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENDERGRAST
Authorized Official - Suffix:
Authorized Official - Credentials:CRISC, CESP
Authorized Official - Phone:202-351-8636
Mailing Address - Street 1:3919 GEORGIA AVE NW
Mailing Address - Street 2:UNIT 1
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5860
Mailing Address - Country:US
Mailing Address - Phone:202-291-7227
Mailing Address - Fax:202-291-0760
Practice Address - Street 1:3919 GEORGIA AVE NW
Practice Address - Street 2:UNIT 1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5860
Practice Address - Country:US
Practice Address - Phone:202-291-7227
Practice Address - Fax:202-291-0760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-24
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services