Provider Demographics
NPI:1295810661
Name:ROBAND ENTERPRISES BODY MIND SPIRIT
Entity type:Organization
Organization Name:ROBAND ENTERPRISES BODY MIND SPIRIT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:RENA
Authorized Official - Last Name:GIVENS-BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-882-0970
Mailing Address - Street 1:4231 BLAGDEN AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20011
Mailing Address - Country:US
Mailing Address - Phone:202-882-0970
Mailing Address - Fax:202-882-4080
Practice Address - Street 1:4231 BLAGDEN AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011
Practice Address - Country:US
Practice Address - Phone:202-882-0970
Practice Address - Fax:202-882-4080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-26
Last Update Date:2012-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2855261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
=========Medicare UPIN