Provider Demographics
NPI:1649651357
Name:PRIORITY HEALTH SYSTEMS INC.
Entity type:Organization
Organization Name:PRIORITY HEALTH SYSTEMS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:FIRMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:DJONTU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-821-4586
Mailing Address - Street 1:94 CARONA COURT
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20905
Mailing Address - Country:US
Mailing Address - Phone:240-821-4586
Mailing Address - Fax:
Practice Address - Street 1:143 KENNEDY ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20011-5228
Practice Address - Country:US
Practice Address - Phone:240-821-4586
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-18
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC171M00000X, 251B00000X
261QD1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC3140N1450XOtherSKILLED NURSING FACILITY- NURSING CARE,PEDIATRIC