| NPI | 1154476091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRANCE LEE BAKER Owner 410-592-9889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MD D0058570) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2023-04-18 |