Organization
MORAN MANOR, LP
Active
Other names
Moran Manor Health Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN PERINI (PRESIDENT)
(301) 745-8700
Entity
Organization
Contact information
Practice address
25701 SHADY LN SW, WESTERNPORT, MD 21562-2017
(301) 359-3000
(301) 359-0121
Mailing address
25701 SHADY LN SW, WESTERNPORT, MD 21562-2017
(301) 359-3000
(301) 359-0121
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
06263199
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510157300
—
MD
01
—
ME4202JW
MD BLUE CROSS BLUE SHIELD
MD
Enumeration date
06/21/2006
Last updated
03/02/2015
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