Organization
LITTLE SISTERS OF THE POOR BALTIMORE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SISTER JOSEPH GRENON RN 35726 (ASSISTANT ADMINISTRATOR)
(410) 744-9367
Entity
Organization
Contact information
Practice address
601 MAIDEN CHOICE LN, ST MARTINS HOME, BALTIMORE, MD 21228-3630
(410) 744-9367
(410) 744-6380
Mailing address
601 MAIDEN CHOICE LN, ST MARTINS HOME, BALTIMORE, MD 21228-3630
(410) 744-9367
(410) 744-6380
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
21D0649848
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
032707700
—
MD
01
—
215354
MEDICARE PTAN
MD
01
—
21D0649848
CLIA
MD
Enumeration date
10/12/2005
Last updated
10/27/2016
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