Organization
RANDALLSTOWN HEALTH CARE LLC
Active
Other names
Chapel Hill Nursing Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN GOEDEKE (PRESIDENT)
(410) 922-2443
Entity
Organization
Contact information
Practice address
4511 ROBOSSON RD, RANDALLSTOWN, MD 21133-1018
(410) 922-2443
Mailing address
4511 ROBOSSON RD, RANDALLSTOWN, MD 21133-1018
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600112200
—
MD
Enumeration date
03/02/2017
Last updated
03/02/2017
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