Provider Demographics
NPI:1356691034
Name:DISTRICT OF COLUMBIA GOVERNMENT
Entity type:Organization
Organization Name:DISTRICT OF COLUMBIA GOVERNMENT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF TREATMENT
Authorized Official - Prefix:
Authorized Official - First Name:JAVON
Authorized Official - Middle Name:CORY
Authorized Official - Last Name:OLIVER
Authorized Official - Suffix:
Authorized Official - Credentials:LPCDIRECTOR
Authorized Official - Phone:202-727-8940
Mailing Address - Street 1:1300 1ST ST NE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-3335
Mailing Address - Country:US
Mailing Address - Phone:202-727-8940
Mailing Address - Fax:202-727-0092
Practice Address - Street 1:70 N ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3324
Practice Address - Country:US
Practice Address - Phone:202-727-8940
Practice Address - Fax:202-727-0092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-11
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X, 163WA0400X, 343900000X
DCPRC14310101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)Group - Multi-Specialty