Provider Demographics
NPI:1790830982
Name:THE METHODIST HOME OF THE DISTRICT OF COLUMBIA
Entity Type:Organization
Organization Name:THE METHODIST HOME OF THE DISTRICT OF COLUMBIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:JOYCE
Authorized Official - Last Name:SAVOY
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:202-966-7623
Mailing Address - Street 1:4901 CONNECTICUT AVE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2022
Mailing Address - Country:US
Mailing Address - Phone:202-966-7623
Mailing Address - Fax:202-777-3335
Practice Address - Street 1:4901 CONNECTICUT AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2022
Practice Address - Country:US
Practice Address - Phone:202-966-7623
Practice Address - Fax:202-777-3335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC310400000X
DCHFD02-0004314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
No310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC029971100Medicaid
DC029971100Medicaid