STODDARD ADULT DAY CARE CENTER LLC (NPI# 1396103891) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396103891 |
| Entity Type | Organization |
| Organization Name | STODDARD ADULT DAY CARE CENTER LLC |
| Practice Address |
2112 Varnum St Ne Washington DC 20018-3320 |
| Mailing Address |
1818 Newton St Nw Washington DC 20010-1017 |
| Practice Telephone | 2025416153 |
| Mailing Telephone | 2023287400 |
| Enumeration Date | 2016-01-29 |
| Last Update Date | 2016-01-29 |
| Authorized Official Name | STEVEN NASH (CEO) |
| Authorized Official Telephone | 2023287400 |
| Is Organization Subpart | Y |
| Parent Organization Name | STODDARD BAPTIST SERVICES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 311ZA0620X |
Custodial Care Facility Specialization: Adult Care Home |
Nursing & Custodial Care Facilities |
| Street Address |
2112 VARNUM ST NE |
| City | WASHINGTON |
| State | DC |
| Zip Code | 20018-3320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104438712 | Veronica Anita Rose | Technician | 3005 Bladensburg Rd Ne Apt 306, Washington, DC 20018 | 2020-08-17 |
| 1851910293 | Justina Christina Okougbo | Nurse Practitioner | 1242 12th St Ne Washington D.c., Washington, DC 20018 | 2020-04-15 |
| 1821629304 | Claire Cinque | Physical Therapy Assistant | 2601 18th Street Nw, Washington, DC 20018 | 2020-02-03 |
| 1669025474 | Chase Associates, LLC | Community/Behavioral Health | 2300 Washington Pl. Ne, Suite 423, Washington, DC 20018 | 2019-07-20 |
| 1407328446 | Howard Mabry | Psychologist | 2218 Rhode Island Avenue, Washington, DC 20018 | 2018-12-31 |
| 1760968697 | Velma Enjie Tebo | Home Health Aide | 1511 Franklin St Ne Apt 510, Washington, DC 20018 | 2018-07-13 |
| 1346744141 | Jacques Vanel Siewe Mbouwe | Home Health Aide | 3508 Commodore Joshua Barney Drive N.e, Apt #t3, Washington, DC 20018 | 2018-03-19 |
| 1376050658 | Marlena Hunt | Technician | 2504 10th St. Ne, Apt 404, Washington, DC 20018 | 2018-01-08 |
| 1245745926 | Mirabel Timben Mbah | Home Health Aide | 2010 Rhode Island Ave, 2nd Floor, North East, DC 20018 | 2017-12-04 |
| 1356855332 | St Judes Dental Clinic | Dentist | 2802 Rhode Island Ave Ne # 1, Washington, DC 20018 | 2017-11-28 |
| Find all providers in zip 20018 | ||||
| Taxonomy Code | 311ZA0620X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Custodial Care Facility |
| Specialization | Adult Care Home |
| A custodial care facility providing supportive and personal care services to disabled and/or elderly individuals who cannot function independently in most areas of activity and need assistance and monitoring to enable them to remain in a home like environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942826755 | Credible Home Health, LLC | Custodial Care Facility | 413 37th Pl Se, Apt 202, Washington, DC 20019-3216 | 2020-06-18 |
| 1700241296 | Inspire Residential Services | Custodial Care Facility | 118 Turnage Dr, Washington, NC 27889-6038 | 2015-12-28 |
| 1275916892 | Cilvic Health Care, Inc | Custodial Care Facility | 1619 28th Pl Se, Washington, DC 20020-3809 | 2015-07-01 |
| 1639587736 | Sumdac, LLC | Custodial Care Facility | 1220 Pamlico St, Washington, NC 27889-3821 | 2014-08-01 |
| 1407280076 | Alcofa Senior Housing, Inc | Custodial Care Facility | 1717 Pennsylvania Ave Nw, Suite 1025, Washington, DC 20006 | 2013-08-30 |
| 1699116715 | Shawnelle Leola Best | Custodial Care Facility | 1440 Cedar St Se Apt 301, Washington, DC 20020-5016 | 2013-07-17 |
| 1952668873 | Kbc Nursing Agency and Home Health Care | Custodial Care Facility | 3213 Dubois Pl Se, Apt 2, Washington, DC 20019-2447 | 2012-04-16 |
| 1841576303 | First Metropolitan Community Services, Inc | Custodial Care Facility | 504 Aspen St Nw, Washington, DC 20012-2740 | 2011-10-28 |
| 1326289182 | Royal Homes | Custodial Care Facility | 6210 N Capitol St Nw, Washington, DC 20011-1416 | 2009-03-08 |
| 1508028556 | Bethlehem House Inc. | Custodial Care Facility | 1401 Lawrence St Ne, Washington, DC 20017-2912 | 2008-07-01 |
| Find all providers in WASHINGTON | ||||
| City | WASHINGTON |
| Zip Code | 20018 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.