Provider Demographics
NPI:1154657088
Name:THE WOMEN'S COLLECTIVE
Entity Type:Organization
Organization Name:THE WOMEN'S COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:NALLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-483-7003
Mailing Address - Street 1:PO BOX 73250
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20056-3250
Mailing Address - Country:US
Mailing Address - Phone:202-483-7003
Mailing Address - Fax:202-483-7330
Practice Address - Street 1:1277 BRENTWOOD RD NE
Practice Address - Street 2:#1
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1042
Practice Address - Country:US
Practice Address - Phone:202-483-7003
Practice Address - Fax:202-483-7330
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC52192XXXX65001627251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC038685100Medicaid