ECKINGTON HOUSE MENTAL HEALTH SERVICE LLC (NPI# 1386164705) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386164705 |
| Entity Type | Organization |
| Organization Name | ECKINGTON HOUSE MENTAL HEALTH SERVICE LLC |
| Practice Address |
3030 30th St Se Washington DC 20020-1674 |
| Mailing Address |
217 T St Ne Washington DC 20002-1530 |
| Practice Telephone | 2028700701 |
| Practice Fax Number | 2025063522 |
| Mailing Telephone | 2028700701 |
| Mailing Fax Number | 2025063522 |
| Enumeration Date | 2017-06-27 |
| Last Update Date | 2017-08-21 |
| Authorized Official Name | JOYCE STEPHENS (CEO) |
| Authorized Official Telephone | 2028700701 |
| Authorized Official Credential | JURIS DOCTORATE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 310400000X | Assisted Living Facility | Nursing & Custodial Care Facilities | ||
| N | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities | ||
| N | 385HR2060X |
Respite Care Specialization: Respite Care, Mental Retardation and/or Developmental Disabilities, Child |
Respite Care Facility | ||
| Y | 320900000X | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | Residential Treatment Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DC | 040837200 | 05 |
| Street Address |
3030 30TH ST SE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20020-1674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326503707 | Mary Alise Fuller | Technician | 3030 30th St Se, Washington, DC 20020-1674 | 2019-02-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043834294 | Monique Holland | Community Health Worker | 3001 O Street Se, Washington, DC 20020 | 2020-06-03 |
| 1215566708 | Ryan Wright | Counselor | Integrated Behavioral Solutions Group Inc., 3200 S St. S.e., Washington, DC 20020 | 2020-04-06 |
| 1316581002 | Kamara King | Hospitalist | 2754 Bruce Pl Se, Washington, DC 20020 | 2019-11-05 |
| 1639720394 | Denise Anderson | Technician | 2401 Bryan Pl S.e, Washington, DC 20020 | 2019-09-24 |
| 1629628664 | Rayniece Ann Johnson | Technician | 1641 W.st Se #303, Washington, DC 20020 | 2019-09-11 |
| 1780245787 | Connie Kitchings | Technician | 2800 Shipley Terrace Se, Washington, DC 20020 | 2019-06-21 |
| 1922560366 | Neka Ramsey-lee | Counselor | Anacostia Community Health Center, 1500 Galen Street, Se, Washington, DC 20020 | 2019-04-04 |
| 1750843553 | Chloe Rebecca Zaitlin | Psychologist | 2600 Douglass Rd. Se, Washington, DC 20020 | 2019-04-02 |
| 1356814974 | Ferris Antwan Alston | Technician | 2100 Mlk Jr Ave S.e., Suite#100, Washington, DC 20020 | 2019-01-07 |
| 1083182471 | Aaron Joshua Jones | Technician | 1432 T Street Se, 1432 T Street Se, Washington, DC 20020 | 2018-11-05 |
| Find all providers in zip 20020 | ||||
| Taxonomy Code | 320900000X |
| Grouping | Residential Treatment Facilities |
| Classification | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
| A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982202271 | Berkeley House Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 817 Elder St Nw, Washington, DC 20012-2323 | 2020-10-09 |
| 1003451873 | Petra Jua | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2205 16th St Se, Washington, DC 20020-4333 | 2019-11-15 |
| 1396202511 | Umbrella Health Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2301 Georgia Ave Nw, Washington, DC 20001-3000 | 2019-02-24 |
| 1184180408 | N2 Care Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 61 Washington Square Cir, Washington, NJ 07882-2486 | 2019-02-11 |
| 1871074567 | Community Empowerment Opportunities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 64 New York Ave Ne Ste 100, Washington, DC 20002-3400 | 2018-08-22 |
| 1760989917 | Innovative Life Solutions Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1703 Frankford St Se, Washington, DC 20020-6309 | 2018-04-12 |
| 1780196915 | Empowering Home Services LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 66 S St Nw, Washington, DC 20001-1128 | 2017-10-27 |
| 1942729694 | Human Development Coalition | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 313 Parkland Pl Se, Washington, DC 20032-1601 | 2017-09-13 |
| 1760900633 | The Arc, Warren County Chapter | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 21 Whites Rd, Washington, NJ 07882-3614 | 2017-08-31 |
| 1841718681 | The Arc, Warren County Chapter | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 66 Park Ave Apt G2, Washington, NJ 07882-1847 | 2017-08-31 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20020 |
Please comment or provide details below to improve the information on ECKINGTON HOUSE MENTAL HEALTH SERVICE LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.