| NPI | 1598989477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA LAVONNE GREEN Physical Therapy Assistant 410-674-3755 |
| Organization Subpart ? | No |
| Primary Taxonomy | 313M00000X Nursing Facility/Intermediate Care Facility (Licence: MD A2933) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2023-09-06 |