Organization
AGLOW RECOVERY HEALTHCARE SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERNIBA Y GHONEIM (CO-OWNER)
(202) 621-8713
Entity
Organization
Contact information
Practice address
1647 BENNING RD NE STE 300A, WASHINGTON, DC 20002-4572
(202) 621-8713
(202) 946-7091
Mailing address
2490 MARKET ST NE # 630, WASHINGTON, DC 20018-3851
(202) 621-8713
(202) 946-7091
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Enumeration date
12/16/2022
Last updated
02/14/2023
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