| NPI | 1821218066 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRET STINE Administrator 410-662-4293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: MD 30-039) |
| Additional Taxonomies | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2007-04-30 |
| Last Update Date | 2020-02-04 |