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NPI Code Detail

MEDICARE: GRANT PARK NURSING HOME LIMITED PARTNERSHIP

MEDICARE: GRANT PARK NURSING HOME LIMITED PARTNERSHIP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing FacilityHFD02-0017DC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1033143235
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANT PARK NURSING HOME LIMITED PARTNERSHIP
Provider Business Mailing Address
First Line : 5000 NANNIE HELEN BURROUGHS AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-5506
Country : US
Telephone Number : 202-399-7504
Fax Number : 202-396-7213
Provider Business Practice Location Address
First Line : 5000 NANNIE HELEN BURROUGHS AVE NE
Second Line :
City : WASHINGTON
State : DC
Zip : 20019-5506
Country : US
Telephone Number : 202-399-7504
Fax Number : 202-396-7213
Authorized Official
Title or Position : MANAGER
Name : SANDRA E. DURHAM
Credential :
Telephone Number : 202-399-7504
Provider Enumeration Date : 07/11/2006
Last Update Date : 03/25/2010

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Directions to “GRANT PARK NURSING HOME LIMITED PARTNERSHIP ” Practice Location

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