Organization
GENESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS AMANDA MARTIN (PTA)
(240) 210-4075
Entity
Organization
Contact information
Practice address
15625 WOODLAND POINT RD, NEWBURG, MD 20664-6304
(240) 210-4075
Mailing address
15625 WOODLAND POINT RD, NEWBURG, MD 20664-6304
(240) 210-4075
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
A3594
MD
Other
Enumeration date
12/04/2012
Last updated
12/04/2012
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