| Beautiful Minds Llc | |
|
6323 Georgia Ave Nw Washington DC 20011-1101 | |
| (301) 379-4211 | |
| Not Available |
| Full Name | Beautiful Minds Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 6323 Georgia Ave Nw, Washington, District Of Columbia |
| Authorized Official Name and Position | John S Smith (MEMBER) |
| Authorized Official Contact | 2406443578 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beautiful Minds Llc 6323 Georgia Ave Nw Washington DC 20011-1101 Ph: () - | Beautiful Minds Llc 6323 Georgia Ave Nw Washington DC 20011-1101 Ph: (301) 379-4211 |
| NPI Number | 1518795590 |
|---|---|
| Provider Enumeration Date | 07/23/2024 |
| Last Update Date | 12/03/2024 |
| Certification Date | 12/03/2024 |
| Medicare PECOS PAC ID | 2668900184 |
|---|---|
| Medicare Enrollment ID | O20250113000743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518795590 | NPI | - | NPPES |
| Provider Name | Jeanette Ethridge |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689334773 PECOS PAC ID: 3971947870 Enrollment ID: I20240220000348 |
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