Provider Demographics
NPI:1639467939
Name:NYAME NTI NATURAL HEALTH SOLUTIONS, LLC
Entity Type:Organization
Organization Name:NYAME NTI NATURAL HEALTH SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AMA
Authorized Official - Middle Name:ASANTEWAA
Authorized Official - Last Name:TYUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-491-5687
Mailing Address - Street 1:3424 N ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-2958
Mailing Address - Country:US
Mailing Address - Phone:202-491-5687
Mailing Address - Fax:202-478-1677
Practice Address - Street 1:3424 N ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-2958
Practice Address - Country:US
Practice Address - Phone:202-491-5687
Practice Address - Fax:202-478-1677
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-20
Last Update Date:2017-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261Q00000X
DCMD035123261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC042875200Medicaid