Healthcare Provider Details

I. General information

NPI: 1053407122
Provider Name (Legal Business Name): WASHINGTON CENTER FOR AGING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 08/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2601 18TH ST NE
WASHINGTON DC
20018-1301
US

IV. Provider business mailing address

2601 18TH ST NE
WASHINGTON DC
20018-1301
US

V. Phone/Fax

Practice location:
  • Phone: 202-541-6200
  • Fax: 202-541-6191
Mailing address:
  • Phone: 202-541-6200
  • Fax: 202-541-6191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number35000052698
License Number StateDC

VIII. Authorized Official

Name: MRS. WILLISTINE PAGE
Title or Position: ADMINISTRATOR
Credential: LNHA
Phone: 202-541-6058