Provider Demographics
NPI:1790390128
Name:TOTAL-RAZZAQ
Entity Type:Organization
Organization Name:TOTAL-RAZZAQ
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KELVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FORD
Authorized Official - Suffix:JR
Authorized Official - Credentials:PEER RECOVERY
Authorized Official - Phone:202-247-1580
Mailing Address - Street 1:2335 ALTAMONT PL SE APT 412
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4107
Mailing Address - Country:US
Mailing Address - Phone:202-247-1580
Mailing Address - Fax:
Practice Address - Street 1:1510 H ST NW STE 800
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20005-1011
Practice Address - Country:US
Practice Address - Phone:202-492-8781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-11
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes405300000XOther Service ProvidersPrevention ProfessionalGroup - Multi-Specialty