Provider Demographics
NPI:1679217244
Name:MARYS CENTER FOR MATERNAL AND CHILD CARE INC
Entity Type:Organization
Organization Name:MARYS CENTER FOR MATERNAL AND CHILD CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:TOLLIE
Authorized Official - Middle Name:BURKE
Authorized Official - Last Name:ELLIOTT
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:202-745-3119
Mailing Address - Street 1:2333 ONTARIO RD NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-2627
Mailing Address - Country:US
Mailing Address - Phone:202-483-8196
Mailing Address - Fax:202-483-0302
Practice Address - Street 1:8908 RIGGS RD
Practice Address - Street 2:
Practice Address - City:ADELPHI
Practice Address - State:MD
Practice Address - Zip Code:20783-1632
Practice Address - Country:US
Practice Address - Phone:844-796-2797
Practice Address - Fax:301-422-5935
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-20
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty