Carolyn Boone Lewis Health Care Center INC
Skilled Nursing Facility in Washington, DC. Organization (NPI-2).
NPI number1124162300
StatusActive
Last updated in NPPESMar 4, 2011
Details
- NPI
- 1124162300
- Entity type
- Organization (NPI-2)
- Legal business name
- Carolyn Boone Lewis Health Care Center INC
- Organization subpart
- No
- Enumeration date
- Feb 19, 2007
- Last updated
- Mar 4, 2011
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 314000000X | Skilled Nursing Facility | B131064 | DC | Yes |
Other names
- Greater Southeast Community Center For The Aging INC (Former Legal Business Name)
Practice location
1380 Southern Ave SeWashington, DC 20032-4623
Phone 202-279-5828
Mailing address
1380 Southern Ave SeWashington, DC 20032-4623
Phone 202-279-5828
Authorized official
Joseph B Tucker
Sr Vice President/Cfo
3016869010
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