Individual
JEROME BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 BELLEVUE ST SE, WASHINGTON, DC 20032-6030
(202) 562-4939
Mailing address
171 SOMERVELLE ST APT 410, ALEXANDRIA, VA 22304-8651
(301) 385-3071
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
05/19/2023
Last updated
12/18/2023
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