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Organization

ICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CLOTILDE ANDJONGO BITOMO (HHA)
(240) 467-4139
Entity
Organization

Contact information

Practice address
1234 SOUTHERN AVE SE APT 301, WASHINGTON, DC 20032-4620
(240) 467-4139
Mailing address
1234 SOUTHERN AVE SE APT 301, WASHINGTON, DC 20032-4620
(240) 467-4139

Taxonomy

Speciality
Code
Description
License number
State
3104A0625X
Assisted Living Facility (Mental Illness)
Primary
HHA10972
DC

Other

Enumeration date
10/08/2014
Last updated
10/08/2014
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