Historic Healthcare Services, LLC

Primary specialty

Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X

Legal business name

HISTORIC HEALTHCARE SERVICES, LLC

Practice address

1629 K St NW
Washington, DC 20006-1602

Phone

(301) 332-9778

NPI assigned

Dec 6, 2022

Organization subpart

No

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

Authorized official

Name

Joebrian Lemnyuytar

Title

Ceo

Phone

(240) 495-8331

Specialties & licenses 2

Addresses

Tax ID family

Historic Healthcare Services2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Historic Healthcare Services

  • Mental Health Counselor
  • Washington, DC
  • NPI 1306797352
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Brian Bonbaar Lemnyuy

  • Community Health Worker
  • Washington, DC
  • NPI 1023459542
  NPD

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

{
    "created_epoch": "1670284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1670284800000",
    "number": "1518678044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 K ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061602",
            "telephone_number": "301-332-9778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 K ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200061602",
            "telephone_number": "301-332-9778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HISTORIC HEALTHCARE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-06",
        "last_updated": "2022-12-06",
        "certification_date": "2022-12-06",
        "status": "A",
        "authorized_official_last_name": "LEMNYUYTAR",
        "authorized_official_first_name": "JOEBRIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-495-8331"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Hirtz, MD
• Cody Keith Hislop
• Anne Marie Histon Kellner, OT
• Christiana Histon-Bey
• Historic Healthcare Services
• Taphne Hitchcockmiller
• Ebony Hizell
• Regina Carla Hizmo
• Melissa Decardi Hladek, CRNP
• Kathryn Hlavin, PT

• Developmental Disabilities Clinic/Center in Washington, DC
• Providers in Washington, DC by specialty
• Developmental Disabilities Clinic/Center in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2022; 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.