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Organization
MBI
Active
Organization
MBI
Active
Parent organization
MBI
Organization subpart
Yes
Provider details
NPI number
Legal business name
MBI
Authorized official
ANDRE WANTEU (HHA)
(202) 725-9450
Entity
Organization
Contact information
Practice address
115 MISSOURI AVE NW APT 4, WASHINGTON, DC 20011-5241
(202) 725-9450
Mailing address
115 MISSOURI AVE NW APT 4, WASHINGTON, DC 20011-5241
(202) 725-9450
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
HHA9059
DC
Other
Enumeration date
06/26/2014
Last updated
06/26/2014
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