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Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARIAMA MAGONA (MANAGER)
(240) 542-4195
Entity
Organization

Contact information

Practice address
5020 SUNNYSIDE AVE STE 222, BELTSVILLE, MD 20705-2307
(240) 542-4195
Mailing address
5020 SUNNYSIDE AVE STE 222, BELTSVILLE, MD 20705-2307

Taxonomy

Speciality
Code
Description
License number
State
3140N1450X
Pediatric Skilled Nursing Facility
Primary

Other

Enumeration date
08/24/2020
Last updated
08/24/2020
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