Provider Demographics
NPI:1841763216
Name:ADVANCED HEALTH SERVICES, LLC
Entity Type:Organization
Organization Name:ADVANCED HEALTH SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:OLAWUNI
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:202-722-5220
Mailing Address - Street 1:1320 FORT STEVENS DR NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-5027
Mailing Address - Country:US
Mailing Address - Phone:202-722-5220
Mailing Address - Fax:
Practice Address - Street 1:1320 FORT STEVENS DR NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5027
Practice Address - Country:US
Practice Address - Phone:202-722-5220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-08
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)