Organization
MARYLAND BAPTIST AGED HOME OF THE UNITED BAPTIST MISSIONARY CONVEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LAVERN JONES (ADMINISTRATOR)
(410) 945-7650
Entity
Organization
Contact information
Practice address
2801 RAYNER AVE, BALTIMORE, MD 21216-4628
(410) 624-3964
Mailing address
2801 RAYNER AVE, BALTIMORE, MD 21216-4628
(410) 624-3964
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
30-081
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
301187900
—
MD
Enumeration date
05/31/2006
Last updated
05/14/2012
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