| NPI | 1720085897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME DAVID POTTER Information Systems Manager 443-471-1004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MD 03-003) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2011-10-24 |