Organization
6012 JEFFERSON BOULEVARD OPCO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM STERN (CFO)
(877) 567-0402
Entity
Organization
Contact information
Practice address
6012 JEFFERSON BLVD, FREDERICK, MD 21703-6953
(732) 358-6883
Mailing address
14C 53RD ST, BROOKLYN, NY 11232-2644
(877) 567-0402
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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