Organization
RIDGELY RETREAT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANDREA LEE LICHTENSTEIN RN (OWNER)
(443) 433-0462
Entity
Organization
Contact information
Practice address
203 RIDGELY AVE, ANNAPOLIS, MD 21401-1303
(443) 433-0462
(443) 433-0491
Mailing address
203 RIDGELY AVE, ANNAPOLIS, MD 21401-1303
(443) 433-0462
(443) 433-0491
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
476282
MD
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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