Organization
CROFTON CONVALESCENT CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PHILIP J GORDON (NURSING HOME ADMINISTRATOR)
(410) 721-1000
Entity
Organization
Contact information
Practice address
2131 DAVIDSONVILLE RD, CROFTON, MD 21114-1632
(410) 721-1000
(410) 721-2749
Mailing address
2131 DAVIDSONVILLE RD, CROFTON, MD 21114-1632
(410) 721-1000
(410) 721-2749
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
02-011
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
021797200
—
MD
Enumeration date
03/03/2006
Last updated
08/14/2012
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