Provider Demographics
NPI:1982202271
Name:BERKELEY HOUSE INC.
Entity Type:Organization
Organization Name:BERKELEY HOUSE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:HEKIMA
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, DDA CERT-MARYLA
Authorized Official - Phone:240-305-2723
Mailing Address - Street 1:817 ELDER ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20012-2323
Mailing Address - Country:US
Mailing Address - Phone:240-305-2723
Mailing Address - Fax:
Practice Address - Street 1:817 ELDER ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2323
Practice Address - Country:US
Practice Address - Phone:240-305-2723
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-09
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities