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)CodeLicenseStatePrimary
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

Other providers in Washington, DC

All providers in Washington, DC · Community/Behavioral Health Agency in District of Columbia

Sources for this page

Verify at the official NPI Registry.