# CRYSTAL CITY NURSING CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Potomac Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104861038
- **Authorized official:** JANE DROPESKEY (CORPORATE MANAGER)
- **Authorized official phone:** (610) 925-4231

## Contact information

- **Practice address:** 1785 S HAYES ST, ARLINGTON, VA 22202-2714
- **Practice address phone:** (703) 920-5700
- **Practice address fax:** (703) 979-8190
- **Mailing address:** 101 E STATE ST, KENNETT SQUARE, PA 19348-3109
- **Mailing address phone:** (610) 925-4436
- **Mailing address fax:** (610) 925-4351

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2655 | VA | Yes |

## Other

- **Enumeration date:** 06/17/2006
- **Last updated:** 08/17/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 004951140 | — | VA |
| 01 | — | 0082366 | AETNA-HMO | — |
| 01 | — | 02PV | CAREFIRST-PROV/INQ\# | — |
| 05 | — | 030909900 | — | DC |
| 01 | — | 147180 | SOUTHERN HEALTH | — |
| 01 | — | 241381 | UNITED - MAMSI | — |
| 01 | — | 47579 | AMERIGROUP | — |
| 01 | — | 7100077 | UNITED - AMERICHOICE | — |
| 01 | — | H18 | CAREFIRST BLUECHOICE | — |