Provider Demographics
NPI:1669033106
Name:PREVENTIVE MEASURE OF WASHINGTON DC, LLC
Entity Type:Organization
Organization Name:PREVENTIVE MEASURE OF WASHINGTON DC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHERYL
Authorized Official - Middle Name:MICHELE
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-510-2019
Mailing Address - Street 1:2759 MARTIN LUTHER KING JR AVE SE STE B7
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2648
Mailing Address - Country:US
Mailing Address - Phone:202-563-7632
Mailing Address - Fax:
Practice Address - Street 1:7826 EASTERN AVE NW STE 201
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1333
Practice Address - Country:US
Practice Address - Phone:202-849-8798
Practice Address - Fax:202-478-2823
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PREVENTIVE MEASURE OF WASHINGTON DC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health