Organization
GOODWILL MENNONITE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN MILLER (CEO)
(301) 895-5194
Entity
Organization
Contact information
Practice address
891 DORSEY HOTEL RD, GRANTSVILLE, MD 21536-1369
(301) 895-5194
(301) 895-3704
Mailing address
891 DORSEY HOTEL RD, GRANTSVILLE, MD 21536-1369
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
11-003
MD
Other
Enumeration date
06/01/2006
Last updated
08/22/2020
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