Healthcare Provider Details

I. General information

NPI: 1699149138
Provider Name (Legal Business Name): DOWNTOWN CLUSTER'S GERIATRIC DAY CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2015
Last Update Date: 11/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

926 11TH ST NW
WASHINGTON DC
20001-4408
US

IV. Provider business mailing address

926 11TH ST NW
WASHINGTON DC
20001-4408
US

V. Phone/Fax

Practice location:
  • Phone: 202-347-7527
  • Fax: 202-347-6983
Mailing address:
  • Phone: 202-347-7527
  • Fax: 202-347-6983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0600X
TaxonomyAdult Day Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. THOMYE MOBLEY CAVE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 202-347-7527