Healthcare Provider Details

I. General information

NPI: 1902115611
Provider Name (Legal Business Name): NOT-FOR-PROFIT HOSPITAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1310 SOUTHERN AVE SE SUITE 200
WASHINGTON DC
20032-4623
US

IV. Provider business mailing address

1310 SOUTHERN AVE SE SUITE 200
WASHINGTON DC
20032-4623
US

V. Phone/Fax

Practice location:
  • Phone: 202-688-4677
  • Fax: 202-574-7188
Mailing address:
  • Phone: 202-688-4677
  • Fax: 202-574-7188

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: BILLY GREEN
Title or Position: DIRECTOR, OUTPATIENT CLINICS & HEAL
Credential:
Phone: 202-688-4677