Organization
HAVEN NURSING HOME, INC
Active
Other names
Arlington West Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. AL L HOLSOPPLE NHA (ADMINISTRATOR)
(410) 664-9535
Entity
Organization
Contact information
Practice address
3939 PENHURST AVE, BALTIMORE, MD 21215-5632
(410) 664-9535
(410) 664-0806
Mailing address
3939 PENHURST AVE, BALTIMORE, MD 21215-5632
(410) 664-9535
(410) 664-0806
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
30074
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300687500
—
MD
Enumeration date
06/10/2005
Last updated
01/02/2009
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