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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ALANA HAYNES (CEO)
(202) 427-9066
Entity
Organization

Contact information

Practice address
3119 BERRY RD NE, WASHINGTON, DC 20018-1609
(202) 427-9066
Mailing address
3119 BERRY RD NE, WASHINGTON, DC 20018-1609

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
241S00000X
DC

Other

Enumeration date
01/29/2011
Last updated
01/29/2011
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