Organization
MAGNOLIA GARDENS LLC
Active
Other names
Doctors Community Rehabilitation and Patient Care Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
6710 MALLERY DR, LANHAM, MD 20706-3964
(301) 552-2000
Mailing address
6710 MALLERY DR, LANHAM, MD 20706-3964
(301) 552-2000
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16011
MD
225X00000X
Occupational Therapist
16011
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300304300
—
MD
Enumeration date
06/03/2016
Last updated
08/29/2017
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