Organization
PRIME CREATIVE HEALTH SERVICE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUSTIN NWAETE (CEO)
(301) 537-9307
Entity
Organization
Contact information
Practice address
1110 ASPEN ST NW APT 101, WASHINGTON, DC 20012-2518
(301) 537-9307
Mailing address
1110 ASPEN ST NW APT 101, WASHINGTON, DC 20012-2518
(301) 537-9307
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
DC
Other
Enumeration date
04/12/2015
Last updated
04/12/2015
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