Organization
313 HOSPITAL DRIVE OPCO LLC
Active
Other names
Autumn Lake Healthcare at Baltimore Washington
Organization subpart
No
Provider details
NPI number
Authorized official
SAM STERN (CFO)
(877) 567-0402
Entity
Organization
Contact information
Practice address
313 HOSPITAL DR, GLEN BURNIE, MD 21061-5803
(410) 761-1222
Mailing address
14C 53RD ST, BROOKLYN, NY 11232-2644
(877) 567-0402
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
—
—
314000000X
Skilled Nursing Facility
Primary
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
03/23/2022
Last updated
03/23/2022
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