Organization
OUR HOUSE ASSISTED LIVING FACILITY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JACQUELINE D MASON (OWNER/MANAGER)
(443) 205-7543
Entity
Organization
Contact information
Practice address
8248 MIMICO S, MILLERSVILLE, MD 21108-1145
(410) 987-2046
Mailing address
8248 MIMICO S, MILLERSVILLE, MD 21108-1145
(410) 987-2046
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
02AL0299
MD
Other
Enumeration date
05/18/2011
Last updated
05/18/2011
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