Organization
RIDGEWAY MANOR INC
Active
Other names
Ridgeway Manor Nursing Home
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN EDGAR BURLEIGH III NURSING HOME ADMINIS (ADMINISTRATOR)
(410) 747-5250
Entity
Organization
Contact information
Practice address
5743 EDMONDSON AVE, CATONSVILLE, MD 21228
(410) 747-5250
(410) 747-8050
Mailing address
5743 EDMONDSON AVE, CATONSVILLE, MD 21228
(410) 747-5250
(410) 747-8050
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
03032
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032927400
—
MD
01
—
59005301
BLUE CROSS BLUE SHIELD
MD
Enumeration date
12/27/2006
Last updated
11/23/2011
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