Organization
BROOKE GROVE FOUNDATION, INC.
Active
Other names
Williamsport Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH SPILLANE (DIR. OF CORP. FINANCE)
(301) 388-7204
Entity
Organization
Contact information
Practice address
154 N ARTIZAN ST, WILLIAMSPORT, MD 21795-1104
(301) 924-2811
(301) 924-1200
Mailing address
18100 SLADE SCHOOL RD, SANDY SPRING, MD 20860-1313
(301) 924-2811
(301) 924-1200
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
21-014
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21760760000
—
MD
Enumeration date
05/10/2007
Last updated
01/11/2024
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