Healthcare Provider Details

I. General information

NPI: 1124027404
Provider Name (Legal Business Name): THE WASHINGTON HOME
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 07/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 UPTON ST NW
WASHINGTON DC
20016-2299
US

IV. Provider business mailing address

3720 UPTON ST NW
WASHINGTON DC
20016-2299
US

V. Phone/Fax

Practice location:
  • Phone: 301-560-6075
  • Fax: 301-560-6075
Mailing address:
  • Phone: 202-895-0192
  • Fax: 202-895-0190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberHFD020005
License Number StateDC

VIII. Authorized Official

Name: MS. SIHAM ANDRAOS
Title or Position: REIMBURSEMENT DIRECTOR
Credential:
Phone: 301-560-6075