Organization
A DAWN HOME LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DAWN COOPER RN (MANAGER)
(410) 905-3654
Entity
Organization
Contact information
Practice address
4994 BEAVERBROOK RD, COLUMBIA, MD 21044-1408
(410) 905-3654
Mailing address
4994 BEAVERBROOK RD, COLUMBIA, MD 21044-1408
(410) 905-3654
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
13AL0232-C
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5689505100
MARYLAND DEPARTMENT OF AGING MEDICAL CARE PROGRAM
MD
Enumeration date
02/09/2012
Last updated
02/09/2012
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