Individual
MR. GEORGE CLEVELAND HENDERSON JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
900 G ST NE APT 502, WASHINGTON, DC 20002-7414
(856) 895-1535
Mailing address
900 G ST NE APT 502, WASHINGTON, DC 20002-7414
(856) 895-1535
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary
FS-103770
DC
332U00000X
Home Delivered Meals
FS-103770
DC
374K00000X
Religious Nonmedical Practitioner
—
—
Other
Enumeration date
06/07/2024
Last updated
06/07/2024
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