Providence Health Services

LBN: Phs Behavioral Medicine
Providence Health Services is an health care organization with primary practice located at 1053 Buchanan St Ne Suite 055, Washington DC 20017-2712. The organization recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Allopathic & Osteopathic Physicians / Neurology, Hospitals / General Acute Care Hospital. Allopathic & Osteopathic Physicians / Addiction Medicine is the primary health care specialty. Phs Behavioral Medicine can be contacted via phone (202) 269-7626, or through Haberkern, Charles F via phone (202) 854-4255.

Contact Information

Primary practice address
1053 Buchanan St Ne Suite 055 Washington DC 20017-2712
Phone: (202) 269-7626
Fax: (202) 269-7616
Website:
Map and Directions
Authorized official contact:
Name: Haberkern, Charles F
Phone: (202) 854-4255

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 2084A0401X HFD01-0212 District of Columbia
Allopathic & Osteopathic Physicians / Neurology 2084N0400X HFD01-0212 District of Columbia
Hospitals / General Acute Care Hospital 282N00000X HFD01-0112 District of Columbia

Profile Details

NPI number 1396012837
LBN Legal business name Phs Behavioral Medicine
DBA Doing business as Providence Health Services
Authorized official Haberkern, Charles F
Entity Organization
Organization subpart 1 Yes
Enumeration date Nov 29th, 2011
Last updated Sep 6th, 2016 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396012837 NPPES
Maryland MEDICAID 005145400
Maryland MEDICAID 09810714
Maryland MEDICAID 029833400

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