Organization
HQM OF MALLARD BAY, LLC
Active
Other names
Mallard Bay Care Center at Cambridge
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL WALCZAK (CEO)
(561) 627-0664
Entity
Organization
Contact information
Practice address
520 GLENBURN AVE, CAMBRIDGE, MD 21613-1415
(410) 228-9191
Mailing address
520 GLENBURN AVE, CAMBRIDGE, MD 21613-1415
(410) 228-9191
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
09006
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
406320100
—
MD
Enumeration date
01/19/2006
Last updated
02/24/2009
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