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Organization

DEPARTMENT OF HEALTH AND MENTAL HYGIENE

Active
Parent organization
STATE OF MARYLAND
Other names
Western Maryland
Organization subpart
Yes

Provider details

NPI number
Legal business name
STATE OF MARYLAND
Authorized official
MOSES ERIAKHA (ACCOUNTANT)
(410) 767-6003
Entity
Organization

Contact information

Practice address
201 W PRESTON ST, 5TH FLOOR, BALTIMORE, MD 21201-2301
(410) 767-6062
Mailing address
201 W PRESTON ST, 5TH FLOOR, BALTIMORE, MD 21201-2301
(410) 767-6062

Taxonomy

Speciality
Code
Description
License number
State
282E00000X
Long Term Care Hospital
Primary
350027600
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
350027600
SKILLED NURSING FACILITY
MD
05
352525200
MD
Enumeration date
12/29/2011
Last updated
12/29/2011
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