Organization
4140 OLD WASHINGTON HIGHWAY OPERATIONS LLC
Active
Other names
Waldorf Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T. BERG (ASSISTANT SECRETARY)
(505) 468-4752
Entity
Organization
Contact information
Practice address
4140 OLD WASHINGTON RD, WALDORF, MD 20602-3221
(301) 645-2813
(301) 645-9317
Mailing address
101 E STATE ST, KENNETT SQUARE, PA 19348-3109
(610) 925-4436
(610) 925-4351
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
08-006
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
413976300
—
MD
Enumeration date
11/23/2007
Last updated
06/03/2021
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