Healthcare Provider Details

I. General information

NPI: 1104984806
Provider Name (Legal Business Name): ARMED FORCES RETIREMENT HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 N CAPITOL ST NW KING HEALTH CENTER
WASHINGTON DC
20011-8400
US

IV. Provider business mailing address

3700 N CAPITOL ST NW KING HEALTH CENTER
WASHINGTON DC
20011-8400
US

V. Phone/Fax

Practice location:
  • Phone: 202-730-3323
  • Fax: 202-730-3047
Mailing address:
  • Phone: 202-730-3323
  • Fax: 202-730-3047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License NumberD21642
License Number StateMD

VIII. Authorized Official

Name: DR. LINDA RADER
Title or Position: ADMINISTRATOR
Credential: PHD
Phone: 202-730-3323