Organization
CANTON HARBOR HEALTHCARE CENTER, INC
Active
Other names
Futurecare Canton
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN FINGLASS (CFO/VP OF FINANCE)
(410) 766-1995
Entity
Organization
Contact information
Practice address
1300 S ELLWOOD AVE, BALTIMORE, MD 21224-4900
(410) 342-6644
(410) 327-3949
Mailing address
8028 RITCHIE HWY, STE 210B, PASADENA, MD 21122-1059
(410) 766-1995
(410) 761-6095
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
30-001
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
197000300
—
MD
01
—
711480000
MEDICAID DME
MD
Enumeration date
06/09/2005
Last updated
01/08/2013
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