Provider Demographics
| NPI: | 1295803856 |
|---|---|
| Name: | SOME, INC |
| Entity type: | Organization |
| Organization Name: | SOME, INC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | PRESIDENT/CEO |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | RALPH |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | BOYD |
| Authorized Official - Suffix: | JR |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 202-797-8806 |
| Mailing Address - Street 1: | 60 O ST NW |
| Mailing Address - Street 2: | |
| Mailing Address - City: | WASHINGTON |
| Mailing Address - State: | DC |
| Mailing Address - Zip Code: | 20001-1258 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 202-797-8806 |
| Mailing Address - Fax: | 202-265-0927 |
| Practice Address - Street 1: | 60 O STREET NW |
| Practice Address - Street 2: | |
| Practice Address - City: | WASHINGTON |
| Practice Address - State: | DC |
| Practice Address - Zip Code: | 20001 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 202-797-8806 |
| Practice Address - Fax: | 202-265-0927 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-12-01 |
| Last Update Date: | 2020-09-03 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 101YA0400X, 1041C0700X, 261QM0801X, 261QM0850X, 261QR0405X, 261QR0800X, 261QF0400X | ||
| DC | DEN1000602 | 1223G0001X |
| DC | MD34147 | 207R00000X |
| DC | MD30525 | 2084P0800X |
| DC | MD16161 | 2084P0800X |
| DC | RN62901 | 363LA2200X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 261QF0400X | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) | Group - Multi-Specialty |
| No | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 1223G0001X | Dental Providers | Dentist | General Practice | Group - Multi-Specialty |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | Group - Multi-Specialty |
| No | 261QM0801X | Ambulatory Health Care Facilities | Clinic/Center | Mental Health (Including Community Mental Health Center) | Group - Multi-Specialty |
| No | 261QM0850X | Ambulatory Health Care Facilities | Clinic/Center | Adult Mental Health | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder | Group - Multi-Specialty |
| No | 261QR0800X | Ambulatory Health Care Facilities | Clinic/Center | Recovery Care | Group - Multi-Specialty |
| No | 363LA2200X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| DC | 019475100 | Medicaid | |
| DC | 080018500 | Medicaid | |
| DC | 019476800 | Medicaid | |
| DC | 074882400 | Medicaid | |
| DC | 036437300 | Medicaid | |
| DC | 1437146305 | Medicare UPIN | |
| DC | 1144326158 | Medicare UPIN | |
| DC | 019476800 | Medicaid | |
| DC | 412563S83 | Medicare ID - Type Unspecified | DR. RON KOSHES' MCR # |
| DC | 012122S83 | Medicare ID - Type Unspecified | DR. MAURICEWRIGHT'S MCR # |
| DC | 019476800 | Medicaid | |
| DC | 412563S83 | Medicare ID - Type Unspecified | DR. RON KOSHES' MCR # |
| DC | 019476800 | Medicaid | |
| DC | 011621S83 | Medicare ID - Type Unspecified | DR. ALICE GASCH'S MCR # |
