MEDICARE: ASSISTED LIVING CENTERS OF AMERICA,LLC

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
1	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1265865349
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSISTED LIVING CENTERS OF AMERICA,LLC

Provider Business Mailing Address
First Line	:	1717 PENNSYLVANIA AVE NW STE 1025
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-3951
Country	:	US
Telephone Number	:	800-463-1641
Fax Number	:

Provider Business Practice Location Address
First Line	:	1717 PENNSYLVANIA AVE NW STE 1025
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20006-3951
Country	:	US
Telephone Number	:	800-463-1641
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	MR. DANIEL J CRAWFORD
Credential	:
Telephone Number	:	202-241-3799

Provider Enumeration Date	:	08/13/2013
Last Update Date	:	08/13/2013

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