Provider Demographics
NPI:1821444282
Name:PACIFIC HEALTHCARE
Entity Type:Organization
Organization Name:PACIFIC HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:EMILIENNE
Authorized Official - Middle Name:WANSI
Authorized Official - Last Name:SINFJUI
Authorized Official - Suffix:
Authorized Official - Credentials:BSN
Authorized Official - Phone:202-413-3230
Mailing Address - Street 1:11104 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:MD
Mailing Address - Zip Code:20902-7622
Mailing Address - Country:US
Mailing Address - Phone:202-413-3230
Mailing Address - Fax:
Practice Address - Street 1:513 FRANKLIN ST NE APT 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1348
Practice Address - Country:US
Practice Address - Phone:202-413-3230
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-04
Last Update Date:2016-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251B00000XAgenciesCase Management
No251E00000XAgenciesHome Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child