Provider Demographics
NPI:1801193198
Name:PREVENTIVE MEASURES OF WASH DC,LLC
Entity Type:Organization
Organization Name:PREVENTIVE MEASURES OF WASH DC,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DWAYNE
Authorized Official - Middle Name:LAFON
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-510-3865
Mailing Address - Street 1:2759 MLK JR AVE SE STE B7
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2648
Mailing Address - Country:US
Mailing Address - Phone:202-563-7632
Mailing Address - Fax:202-478-2823
Practice Address - Street 1:322 HARRY S TRUMAN DR
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-2018
Practice Address - Country:US
Practice Address - Phone:202-510-2019
Practice Address - Fax:202-965-1040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-22
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC70104845251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health