| NPI | 1508854662 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET STINE Administrator 410-662-4293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MD md30039) |
| Enumeration Date | 2005-10-12 |
| Last Update Date | 2020-02-04 |