Provider Demographics
NPI:1023873585
Name:YOUR AMERICAN FAMILY PLLC
Entity type:Organization
Organization Name:YOUR AMERICAN FAMILY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:RICARDO
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:240-432-5234
Mailing Address - Street 1:100 M ST SE STE 674
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-3519
Mailing Address - Country:US
Mailing Address - Phone:240-432-5234
Mailing Address - Fax:
Practice Address - Street 1:100 M ST SE STE 674
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-3519
Practice Address - Country:US
Practice Address - Phone:240-432-5234
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker