Organization
MIND & REASON ADVOCACY GROUP, LLC.
Active
Organization
MIND & REASON ADVOCACY GROUP, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVIAN NIKEITH ISOM MSW (CHIEF EXECUTIVE OFFICER)
(202) 246-6781
Entity
Organization
Contact information
Practice address
2806 POMEROY RD SE, 2808 POMEROY RD SE, WASHINGTON, DC 20020-5912
(202) 246-6781
Mailing address
3511 LESLIE AVE, TEMPLE HILLS, MD 20748-4633
(202) 246-6781
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
323P00000X
Psychiatric Residential Treatment Facility
—
—
Other
Enumeration date
11/12/2012
Last updated
11/12/2012
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