| NPI | 1043217219 |
|---|---|
| Doing Business As | SHADY GROVE NURSING AND REBAH CENTER |
| Entity Type | Organization |
| Authorized Contact | RICHARD A MARIZAN Director, Central Business Office 301-315-3272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2005-07-04 |
| Last Update Date | 2010-01-26 |