1932389723 NPI number — METROPOLITAN BEHAVIORAL HEALTH CARE, LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932389723 NPI number — METROPOLITAN BEHAVIORAL HEALTH CARE, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
METROPOLITAN BEHAVIORAL HEALTH CARE, LLC
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:
Provider Other Organization Name Type Code:
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:
1932389723
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8811 COLESVILLE RD
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
SILVER SPRING
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20910-4343
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-585-5539
Provider Business Mailing Address Fax Number:
301-587-4327

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 17TH ST NW
Provider Second Line Business Practice Location Address:
SUITE 306
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20006-2601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-452-6257
Provider Business Practice Location Address Fax Number:
202-530-0744
Provider Enumeration Date:
11/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KIMBALL
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
LEE
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
202-452-6257

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  PSYC826 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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