Organization
CAROLYN BOONE LEWIS HEALTH CARE CENTER INC
Active
Other names
Greater Southeast Community Center for the Aging Inc
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSEPH B TUCKER (SR VICE PRESIDENT/CFO)
(301) 686-9010
Entity
Organization
Contact information
Practice address
1380 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 279-5828
Mailing address
1380 SOUTHERN AVE SE, WASHINGTON, DC 20032-4623
(202) 279-5828
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
B131064
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022869900
—
DC
Enumeration date
02/19/2007
Last updated
03/04/2011
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