Southern Ave Sp LLC
NPI 1306433644ActiveOrganization· Assisted Living Facility· Washington Dc, DC
Assisted Living Facility in Washington Dc, District of Columbia, registered in NPPES in December 2020. The authorized official on file is Ryan Person, Director Of Business Development.
Overview
| NPI | 1306433644 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Dec 21, 2020 |
| Last updated in NPPES | Jan 26, 2021 |
| Certified by provider | Jan 26, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Assisted Living Facility Primary | 310400000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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