Ics

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

License

HHA10972 Issued in DC

Legal business name

ICS

Practice address

1234 Southern Ave SE Apt 301
Washington, DC 20032-4620

Phone

(240) 467-4139

NPI assigned

Oct 8, 2014

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clotilde Andjongo Bitomo

Title

HHA

Phone

(240) 467-4139

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412726400000",
    "number": "1194128819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1234 SOUTHERN AVE SE APT 301",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324620",
            "telephone_number": "240-467-4139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1234 SOUTHERN AVE SE APT 301",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200324620",
            "telephone_number": "240-467-4139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-08",
        "last_updated": "2014-10-08",
        "status": "A",
        "authorized_official_last_name": "ANDJONGO BITOMO",
        "authorized_official_first_name": "CLOTILDE",
        "authorized_official_title_or_position": "HHA",
        "authorized_official_telephone_number": "240-467-4139"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": "DC",
            "license": "HHA10972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Washington, DC
• Providers in Washington, DC by specialty
• Assisted Living Facility (Mental Illness) in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.