Provider Demographics
NPI:1982001467
Name:HUDAMA KWA JAMII BEHAVIORAL HEALTH SERVICES
Entity Type:Organization
Organization Name:HUDAMA KWA JAMII BEHAVIORAL HEALTH SERVICES
Other - Org Name:HKJBHS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:HEWITT
Authorized Official - Suffix:JR
Authorized Official - Credentials:DRPJ
Authorized Official - Phone:301-928-8036
Mailing Address - Street 1:231 E BALTIMORE ST
Mailing Address - Street 2:SUITE 1402
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-3415
Mailing Address - Country:US
Mailing Address - Phone:301-928-8036
Mailing Address - Fax:
Practice Address - Street 1:231 E BALTIMORE ST
Practice Address - Street 2:SUITE 1402
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-3415
Practice Address - Country:US
Practice Address - Phone:301-928-8036
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3027831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty