Provider Demographics
NPI:1376624841
Name:TEEN CONNECTION OF TAKOMA, INC.
Entity Type:Organization
Organization Name:TEEN CONNECTION OF TAKOMA, INC.
Other - Org Name:TEEN CONNECTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLER-COLBERT
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:301-565-0914
Mailing Address - Street 1:1400 SPRING ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2735
Mailing Address - Country:US
Mailing Address - Phone:301-565-0914
Mailing Address - Fax:
Practice Address - Street 1:1400 SPRING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2735
Practice Address - Country:US
Practice Address - Phone:301-565-0914
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility