MEDICARE: DC HEALTH CARE, INC

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	315P00000X	Intellectual Disabilities Intermediate Care Facility	HFD03-255	DC

General Provider Information

NPI Number	:	1710116751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DC HEALTH CARE, INC

Provider Business Mailing Address
First Line	:	429 FLORIDA AVE NE
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20002-3437
Country	:	US
Telephone Number	:	202-547-2008
Fax Number	:	202-547-2331

Provider Business Practice Location Address
First Line	:	6703 SANDY SPRING RD NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20012-2015
Country	:	US
Telephone Number	:	202-547-2008
Fax Number	:	202-547-2331

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. GRACY STEPHEN
Credential	:	LICSW, ACSW
Telephone Number	:	202-547-2008

Provider Enumeration Date	:	07/13/2009
Last Update Date	:	12/11/2015

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Directions to “DC HEALTH CARE, INC ” Practice Location

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