Organization
SODEXO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AIMEE MARIE MORRIS (CLINICAL NUTRITION MANAGER)
(443) 605-1076
Entity
Organization
Contact information
Practice address
2011 SONG SPARROW CT, HAMPSTEAD, MD 21074-2640
(443) 974-8564
Mailing address
2011 SONG SPARROW COURT, HAMPSTEAD, MD 21074
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
DX2497
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
930925
ADA/CDR
—
01
—
DX2497
MD SATE LICENSE
MD
Enumeration date
09/28/2010
Last updated
09/28/2010
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