Provider Demographics
NPI:1659804482
Name:WILLIAM AND JOHN MONTGOMERY FOUNDATION
Entity Type:Organization
Organization Name:WILLIAM AND JOHN MONTGOMERY FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:
Authorized Official - Credentials:MSW/LICSW
Authorized Official - Phone:202-460-4456
Mailing Address - Street 1:609 RITTENHOUSE ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1238
Mailing Address - Country:US
Mailing Address - Phone:202-460-4456
Mailing Address - Fax:
Practice Address - Street 1:609 RITTENHOUSE ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1238
Practice Address - Country:US
Practice Address - Phone:202-460-4456
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-08
Last Update Date:2017-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC302584251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management