Provider Demographics
NPI:1679809818
Name:CHILD AND FAMILY SERVICES AGENCY
Entity Type:Organization
Organization Name:CHILD AND FAMILY SERVICES AGENCY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SUPV. MEDICAID CLAIM UNIT
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:H
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-715-7803
Mailing Address - Street 1:400 6TH STREET SW
Mailing Address - Street 2:MEDICAID CLAIM UNIT 4TH FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2753
Mailing Address - Country:US
Mailing Address - Phone:202-715-7803
Mailing Address - Fax:202-727-5382
Practice Address - Street 1:400 6TH ST SW
Practice Address - Street 2:MEDICAID CLAIM UNIT 4TH FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2753
Practice Address - Country:US
Practice Address - Phone:202-715-7803
Practice Address - Fax:202-727-5382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service