Organization
16 FUSTING AVENUE OPERATIONS LLC
Active
Other names
Catonsville Commons
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
16 FUSTING AVE, BALTIMORE, MD 21228-4413
(410) 747-1800
(410) 747-0822
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
03-018
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413980100
—
MD
Enumeration date
11/27/2007
Last updated
01/08/2016
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