Organization
SHADY GROVE SNF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ISRAEL BIRNBAUM (AUTHORIZED OFFICIAL)
(732) 905-6440
Entity
Organization
Contact information
Practice address
9701 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3326
(301) 315-1901
Mailing address
9701 MEDICAL CENTER DR, ROCKVILLE, MD 20850-3326
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
05/07/2018
Last updated
05/07/2018
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