Abundant Grace Health Services LLC
Organization Active NPI Community/Behavioral Health Agency · Washington, DC
NPI 1982182150 · NPPES record last updated Jul 31, 2018
Key facts
- NPI
- 1982182150
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Behavioral Health Agency 251S00000X
- License
- 012218-388 (DC)
- Legal business name
- ABUNDANT GRACE HEALTH SERVICES LLC
- Practice address
- 4645 Nannie Helen Burroughs Ave NE
Washington, DC 20019-3622 - Phone
- (240) 468-6009
- NPI assigned
- Jul 31, 2018
- Organization subpart
- No
Authorized official
- Name
- Jeanne Sanja Johnson, NURSE
- Title
- Ceo
- Phone
- (240) 468-6009
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | 012218-388 | DC | Yes |
Addresses
Primary practice location
4645 Nannie Helen Burroughs Ave NE
Washington, DC 20019-3622
Mailing address
4645 Nannie Helen Burroughs Ave NE
Washington, DC 20019-3622
Phone (240) 468-6009
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.