Provider Demographics
NPI:1649769662
Name:ONE CARE DC INC
Entity Type:Organization
Organization Name:ONE CARE DC INC
Other - Org Name:ONE CARE DC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:MATUTU
Authorized Official - Middle Name:
Authorized Official - Last Name:NYABANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-889-0800
Mailing Address - Street 1:1628 GOOD HOPE RD SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4706
Mailing Address - Country:US
Mailing Address - Phone:202-889-0800
Mailing Address - Fax:
Practice Address - Street 1:1628 GOOD HOPE RD SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-4706
Practice Address - Country:US
Practice Address - Phone:240-506-9577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-04
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC102617-337251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health