Provider Demographics
NPI:1851781827
Name:HOLY HEALTH CARE SERVICES LLC
Entity Type:Organization
Organization Name:HOLY HEALTH CARE SERVICES LLC
Other - Org Name:HOLY HEALTH CARE SERVICES LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JULIUS
Authorized Official - Middle Name:YERIMA
Authorized Official - Last Name:BAKARI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:240-350-7378
Mailing Address - Street 1:6210 N CAPITOL ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011-1416
Mailing Address - Country:US
Mailing Address - Phone:202-722-0404
Mailing Address - Fax:202-330-5605
Practice Address - Street 1:6210 N CAPITOL ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-1416
Practice Address - Country:US
Practice Address - Phone:202-722-0404
Practice Address - Fax:202-330-5605
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC084515700101YA0400X, 101YM0800X, 103TP2701X
DC76686101YM0800X
DCGH356251S00000X
261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral HealthGroup - Single Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No103TP2701XBehavioral Health & Social Service ProvidersPsychologistGroup PsychotherapyGroup - Single Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC084515700Medicaid
DC084515700Medicaid