| NPI | 1801879390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY ANN HUBBERT Medical Billing/Accounting Dept. 443-578-8043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 310400000X Assisted Living Facility |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2009-12-17 |