Provider Demographics
NPI:1851618714
Name:STODDARD BAPTIST GLOBAL CARE
Entity Type:Organization
Organization Name:STODDARD BAPTIST GLOBAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:MAHESH
Authorized Official - Middle Name:
Authorized Official - Last Name:TYAGI
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:202-328-7400
Mailing Address - Street 1:1818 NEWTON ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-1017
Mailing Address - Country:US
Mailing Address - Phone:202-328-7400
Mailing Address - Fax:202-328-1083
Practice Address - Street 1:2601 18TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20018-1301
Practice Address - Country:US
Practice Address - Phone:202-328-7400
Practice Address - Fax:202-328-1083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-30
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC314000000X
DCHFD02-0007314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility