Provider Demographics
NPI:1376996082
Name:FAMILY MATTERS OF GREATER WASHINGTO
Entity Type:Organization
Organization Name:FAMILY MATTERS OF GREATER WASHINGTO
Other - Org Name:FAMILY AND CHILD SERVICES
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:TONYA
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON- SMALLWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-289-1510
Mailing Address - Street 1:425 I ST NW STE 700
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-2542
Mailing Address - Country:US
Mailing Address - Phone:202-289-1510
Mailing Address - Fax:
Practice Address - Street 1:4301 9TH ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-6004
Practice Address - Country:US
Practice Address - Phone:202-289-1510
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-18
Last Update Date:2016-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC029975200Medicaid