Provider Demographics
NPI:1043483852
Name:FEDERAL CITY RECOVERY SERVICES
Entity type:Organization
Organization Name:FEDERAL CITY RECOVERY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:PRIMES
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:III
Authorized Official - Credentials:
Authorized Official - Phone:202-236-4362
Mailing Address - Street 1:PO BOX 54790
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-9390
Mailing Address - Country:US
Mailing Address - Phone:202-236-4362
Mailing Address - Fax:
Practice Address - Street 1:601 RALEIGH PL SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-4221
Practice Address - Country:US
Practice Address - Phone:202-735-5579
Practice Address - Fax:202-735-5583
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-12
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QR0405X, 3245S0500X
DC021308A-Y-1863245S0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3245S0500XResidential Treatment FacilitiesSubstance Abuse Rehabilitation FacilitySubstance Abuse Treatment, Children
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC111215-264OtherDC CERTIFICATION