Provider Demographics
NPI:1275849457
Name:DC GOVERNMENT
Entity Type:Organization
Organization Name:DC GOVERNMENT
Other - Org Name:DEPARTMENT OF MENTAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHERMAIN
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-698-1829
Mailing Address - Street 1:821 HOWARD RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-5805
Mailing Address - Country:US
Mailing Address - Phone:202-698-1838
Mailing Address - Fax:202-698-2466
Practice Address - Street 1:821 HOWARD RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5805
Practice Address - Country:US
Practice Address - Phone:202-698-1838
Practice Address - Fax:202-698-2466
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PARENT INFANT EARLY CHILDHOOD ENHANCEMENT PROGRAM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-08-25
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC536001131Medicaid