Provider Demographics
NPI:1790921997
Name:EASTER SEALS SERVING DC/MD/ VA, INC.
Entity Type:Organization
Organization Name:EASTER SEALS SERVING DC/MD/ VA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-920-9703
Mailing Address - Street 1:1420 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2701
Mailing Address - Country:US
Mailing Address - Phone:301-588-8700
Mailing Address - Fax:301-576-5317
Practice Address - Street 1:1420 SPRING ST
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2701
Practice Address - Country:US
Practice Address - Phone:301-920-9713
Practice Address - Fax:301-920-9703
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EASTER SEALS GREATER WASHINGTON REGION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-12-18
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5302145000Medicaid