Organization
ABUNDANT GRACE HEALTH SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANNE SANJA JOHNSON NURSE (CEO)
(240) 468-6009
Entity
Organization
Contact information
Practice address
4645 NANNIE HELEN BURROUGHS AVE NE, WASHINGTON, DC 20019-3622
(240) 468-6009
Mailing address
4645 NANNIE HELEN BURROUGHS AVE NE, WASHINGTON, DC 20019-3622
(240) 468-6009
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
012218-388
DC
Other
Enumeration date
07/31/2018
Last updated
07/31/2018
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