Provider Demographics
NPI:1518792993
Name:WASHINGTON DC HEALTH CENTER INC
Entity type:Organization
Organization Name:WASHINGTON DC HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:
Authorized Official - Last Name:MASSAWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-255-2574
Mailing Address - Street 1:4523 ALABAMA AVE SE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20019-4912
Mailing Address - Country:US
Mailing Address - Phone:202-255-2574
Mailing Address - Fax:
Practice Address - Street 1:4523 ALABAMA AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20019-4912
Practice Address - Country:US
Practice Address - Phone:202-255-2574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities