Healthcare Provider Details

I. General information

NPI: 1144268004
Provider Name (Legal Business Name): COMMUNITY CARE NURSING SERVICES OF DC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2006
Last Update Date: 10/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6031 KANSAS AVE NW SUITE 201
WASHINGTON DC
20011-1566
US

IV. Provider business mailing address

6031 KANSAS AVE NW SUITE 201
WASHINGTON DC
20011-1566
US

V. Phone/Fax

Practice location:
  • Phone: 202-545-5040
  • Fax: 202-545-5043
Mailing address:
  • Phone: 202-545-5040
  • Fax: 202-446-0866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number04-0-8
License Number StateDC

VIII. Authorized Official

Name: MS. MARGARET COLLINS
Title or Position: ADMINISTRATOR
Credential: RN
Phone: 202-545-5040