| Vita Abbodante Llc | |
|
8957 Edmonston Rd Ste C Greenbelt MD 20770-4044 | |
| (202) 815-5525 | |
| Not Available |
| Full Name | Vita Abbodante Llc |
|---|---|
| Speciality | Social Worker |
| Location | 8957 Edmonston Rd Ste C, Greenbelt, Maryland |
| Authorized Official Name and Position | Dorthea L. Crenshaw (CEO) |
| Authorized Official Contact | 2028155525 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vita Abbodante Llc 8957 Edmonston Rd Ste C Greenbelt MD 20770-4044 Ph: (202) 815-5525 | Vita Abbodante Llc 8957 Edmonston Rd Ste C Greenbelt MD 20770-4044 Ph: (202) 815-5525 |
| NPI Number | 1023628021 |
|---|---|
| Provider Enumeration Date | 08/04/2020 |
| Last Update Date | 08/04/2020 |
| Certification Date | 08/04/2020 |
| Medicare PECOS PAC ID | 7012337660 |
|---|---|
| Medicare Enrollment ID | O20201020001884 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023628021 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Dorthea L Crenshaw |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1992147524 PECOS PAC ID: 3779703970 Enrollment ID: I20141010001768 |
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