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General NPI Number Information
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NPI Number | 1255775995
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Entity Type | Organization
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Legal Business Name | COMMUNITY CARE
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Dates
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Enumeration Date | 04/24/2013
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Last Update Date | 04/24/2013
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Provider Practice Location Address
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Address Line | 602 MORTON ST NW 21
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City | WASHINGTON
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State | DC
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Zip | 20010-2542
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Country | US
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Telephone | 202-709-2238
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Fax |
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Provider Business Mailing Address
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Address Line | 602 MORTON ST NW 21
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City | WASHINGTON
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State | DC
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Zip | 20010-2542
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Country | US
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Telephone | 202-709-2238
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Fax |
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Authorized Official
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Title or Position | DIRECTIVE NURSING
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Name | LINZEKA FIELDS
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Credential |
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Telephone | 202-545-5040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 139354
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License Number State | DC
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