Provider Demographics
NPI:1790809978
Name:ACT IV
Entity Type:Organization
Organization Name:ACT IV
Other - Org Name:COMMUNITY SERVICES AGENCY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:RECOVERY SPECIALIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHARLENE
Authorized Official - Middle Name:LIVINIA
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-645-7263
Mailing Address - Street 1:252 OAKWOOD ST SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-1721
Mailing Address - Country:US
Mailing Address - Phone:202-561-3101
Mailing Address - Fax:
Practice Address - Street 1:252 OAKWOOD ST SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-1721
Practice Address - Country:US
Practice Address - Phone:202-561-3101
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDLN1385257251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management