Organization
CHARLES COUNTY NURSING HOME INC
Active
Other names
Charles County Nursing & Rehab Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM M HOLMAN JR. (CHIEF FINANCIAL OFFICER)
(301) 934-1900
Entity
Organization
Contact information
Practice address
10200 LAPLATA RD, LA PLATA, MD 20646-3245
(301) 934-1900
(301) 539-7310
Mailing address
10200 LAPLATA RD, LA PLATA, MD 20646-3245
(301) 934-1900
(301) 539-7310
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
08003
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
024870300
MED B
—
05
—
087007200
—
MD
01
—
472943900
ADC-LAP
MD
01
—
502424200
ADC-BR
MD
Enumeration date
11/08/2005
Last updated
01/07/2010
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