Provider Demographics
NPI:1265095210
Name:NO JUNK FOOD ZONE LLC
Entity type:Organization
Organization Name:NO JUNK FOOD ZONE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ROSANE
Authorized Official - Middle Name:
Authorized Official - Last Name:ST PAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-660-1460
Mailing Address - Street 1:800 MAINE AVE SW STE 200
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20024-2811
Mailing Address - Country:US
Mailing Address - Phone:202-660-1460
Mailing Address - Fax:
Practice Address - Street 1:800 MAINE AVE SW STE 200
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-2811
Practice Address - Country:US
Practice Address - Phone:202-660-1460
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-16
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174H00000XOther Service ProvidersHealth EducatorGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251K00000XAgenciesPublic Health or Welfare
No251S00000XAgenciesCommunity/Behavioral Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC046023836Medicaid