Provider Demographics
NPI:1699149138
Name:DOWNTOWN CLUSTER'S GERIATRIC DAY CARE CENTER, INC.
Entity type:Organization
Organization Name:DOWNTOWN CLUSTER'S GERIATRIC DAY CARE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:THOMYE
Authorized Official - Middle Name:MOBLEY
Authorized Official - Last Name:CAVE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:202-347-7527
Mailing Address - Street 1:926 11TH ST NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-4408
Mailing Address - Country:US
Mailing Address - Phone:202-347-7527
Mailing Address - Fax:202-347-6983
Practice Address - Street 1:926 11TH ST NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4408
Practice Address - Country:US
Practice Address - Phone:202-347-7527
Practice Address - Fax:202-347-6983
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-20
Last Update Date:2015-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC048380800Medicaid