# GOODWIN HOUSE INCORPORATED

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Goodwin House Alexandria
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629069851
- **Authorized official:** MISS KATHLEEN S ANDERSON (CEO)
- **Authorized official phone:** (703) 824-1355

## Contact information

- **Practice address:** 4800 FILLMORE AVE, ALEXANDRIA, VA 22311-5070
- **Practice address phone:** (703) 824-1290
- **Practice address fax:** (703) 824-1241
- **Mailing address:** 4800 FILLMORE AVE, ALEXANDRIA, VA 22311-5070
- **Mailing address phone:** (703) 824-1290
- **Mailing address fax:** (703) 824-1241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | NH2560 | VA | Yes |

## Other

- **Enumeration date:** 11/05/2005
- **Last updated:** 01/11/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 4950577 | — | VA |