1548309289 NPI number — BOARDER BABY PROJECT

Table of content: (NPI 1548309289)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548309289 NPI number — BOARDER BABY PROJECT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BOARDER BABY PROJECT
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LITTLE BLUE HOUSE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1548309289
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
524 IRVING ST NW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20010-2904
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-291-2100
Provider Business Mailing Address Fax Number:
202-723-9227

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
524 IRVING ST NW
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20010-2904
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-291-2100
Provider Business Practice Location Address Fax Number:
202-723-9227
Provider Enumeration Date:
02/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FOSTER
Authorized Official First Name:
CARL
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE VICE PRESIDENT
Authorized Official Telephone Number:
202-291-2100

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  LA624 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: LC00300820 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: LC50077938 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225100000X , with the licence number: PT2725 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X , with the licence number: 04650 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 235Z00000X , with the licence number: 26367 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225X00000X , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)