Provider Demographics
NPI:1932811098
Name:UGIRL LLC
Entity Type:Organization
Organization Name:UGIRL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KINIESHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:ABRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-391-1093
Mailing Address - Street 1:2832 6TH ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1303
Mailing Address - Country:US
Mailing Address - Phone:202-391-1093
Mailing Address - Fax:
Practice Address - Street 1:5211 AUTH RD STE 202B
Practice Address - Street 2:
Practice Address - City:SUITLAND
Practice Address - State:MD
Practice Address - Zip Code:20746-4658
Practice Address - Country:US
Practice Address - Phone:202-719-6119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:UGIRL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-21
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0800XAmbulatory Health Care FacilitiesClinic/CenterRecovery Care