Healthcare Provider Details

I. General information

NPI: 1356456289
Provider Name (Legal Business Name): DCA HADLEY SNF LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4601 MLK JR AVENUE SW
WASHINGTON DC
20032-1131
US

IV. Provider business mailing address

4601 MLK JR AVENUE SW
WASHINGTON DC
20032-1131
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-4170
  • Fax: 202-373-5906
Mailing address:
  • Phone: 202-741-4170
  • Fax: 202-373-5906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License NumberHFD020023
License Number StateDC

VIII. Authorized Official

Name: SWENDA BEITPOULICE
Title or Position: VP & COO
Credential:
Phone: 562-453-7474