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Organization

INNERCITY COLLABORATIVE COMMUNITY DEVELOPMENT CORPORATION

Active
Other names
Homes With A real Heart, Miracle Temple Non Denominational Church Inc.
Organization subpart
No

Provider details

NPI number
Authorized official
REV JUDIE SHEPHERD-GORE JD, MBA (EXECUTIVE DIRECTOR)
(240) 304-6822
Entity
Organization

Contact information

Practice address
5219 CALL PL SE, WASHINGTON, DC 20019-6321
(240) 304-6822
(301) 336-5164
Mailing address
5219 CALL PL SE, WASHINGTON, DC 20019-6321
(240) 304-6822
(301) 336-5164

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
1041C0700X
Clinical Social Worker
251B00000X
Case Management Agency
251S00000X
Community/Behavioral Health Agency

Other

Enumeration date
01/22/2024
Last updated
01/22/2024
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