Organization
IDA MAE CAMPBELL WELLNESS & RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IDEN DONOVAN CAMPBELL-MCCOLLUM (CEO/FOUNDER)
(202) 684-7015
Entity
Organization
Contact information
Practice address
1338 N CAPITOL ST NW, SUITE 101, WASHINGTON, DC 20002-3337
(202) 684-7015
(866) 666-0251
Mailing address
1338 N CAPITOL ST NW, SUITE 101, WASHINGTON, DC 20002-3337
(202) 684-7015
(866) 666-0251
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
251X00000X
Supports Brokerage Agency
—
—
Other
Enumeration date
06/08/2010
Last updated
06/08/2010
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