Provider First Line Business Practice Location Address:
1053 BUCHANAN ST NE
Provider Second Line Business Practice Location Address:
PROVIDENCE HOSPITAL BEHAVIORAL HEALTH OPC-SETON HOUSE
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20017-2712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-363-2575
Provider Business Practice Location Address Fax Number:
301-685-0277
Provider Enumeration Date:
11/05/2007