Healthcare Provider Details

I. General information

NPI: 1316005069
Provider Name (Legal Business Name): JB JOHNSON NURSING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 1ST ST NW
WASHINGTON DC
20001-1403
US

IV. Provider business mailing address

901 1ST ST NW
WASHINGTON DC
20001-1403
US

V. Phone/Fax

Practice location:
  • Phone: 202-535-1100
  • Fax:
Mailing address:
  • Phone: 202-535-1100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: SOLANGES VIVENS
Title or Position: PRESIDENT & CEO
Credential:
Phone: 202-282-3102