Provider Demographics
NPI:1902063795
Name:THE INSTITUTE FOR THE PREVENTION & ERADICATION OF VIOLENCE
Entity Type:Organization
Organization Name:THE INSTITUTE FOR THE PREVENTION & ERADICATION OF VIOLENCE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:CORRINE
Authorized Official - Middle Name:V
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:202-373-1815
Mailing Address - Street 1:4409 S CAPITOL ST SW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20032-2107
Mailing Address - Country:US
Mailing Address - Phone:202-373-1815
Mailing Address - Fax:240-778-6391
Practice Address - Street 1:4409 S CAPITOL ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2107
Practice Address - Country:US
Practice Address - Phone:202-373-1815
Practice Address - Fax:240-778-6391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-20
Last Update Date:2008-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health