Provider Demographics
NPI:1619039930
Name:THE WASHINGTON HOME
Entity Type:Organization
Organization Name:THE WASHINGTON HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REIMBURSEMENT DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SIHAM
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRAOS
Authorized Official - Suffix:
Authorized Official - Credentials:REIMBURSEMENT DIRECT
Authorized Official - Phone:301-560-6075
Mailing Address - Street 1:3720 UPTON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20016-2224
Mailing Address - Country:US
Mailing Address - Phone:301-560-6075
Mailing Address - Fax:202-895-0190
Practice Address - Street 1:3720 UPTON ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-2224
Practice Address - Country:US
Practice Address - Phone:202-895-0192
Practice Address - Fax:202-895-0190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCHFD020005314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC029841500Medicaid
DCG00378Medicare ID - Type Unspecified