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General NPI Number Information
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NPI Number | 1790802288
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Entity Type | Organization
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Legal Business Name | CENTER CARE DAY TREATMENT CENTER
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Dates
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Enumeration Date | 03/22/2007
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Last Update Date | 08/05/2008
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Provider Practice Location Address
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Address Line | 2601 18TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20018-1301
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Country | US
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Telephone | 202-541-6200
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Fax | 202-541-6191
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Provider Business Mailing Address
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Address Line | 2601 18TH ST NE
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City | WASHINGTON
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State | DC
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Zip | 20018-1301
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Country | US
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Telephone | 202-541-6200
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Fax | 202-541-6191
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. WILLISTINE PAGE
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Credential | LICENSE ADMINISTRATO
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Telephone | 202-541-6058
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA0600X
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Taxonomy Name | Adult Day Care Clinic/Center
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License Number | HFD020007
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License Number State | DC
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