Provider Demographics
NPI:1093983827
Name:ROCK CREEK NURSING CENTER INC
Entity Type:Organization
Organization Name:ROCK CREEK NURSING CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTROLLER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANGERER
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-738-9400
Mailing Address - Street 1:2131 O ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20037-1008
Mailing Address - Country:US
Mailing Address - Phone:301-738-9400
Mailing Address - Fax:301-738-7145
Practice Address - Street 1:2131 O ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20037-1008
Practice Address - Country:US
Practice Address - Phone:301-738-9400
Practice Address - Fax:301-738-9400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-14
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHFD020001314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC095031Medicare Oscar/Certification