Organization
SOUTH MOUNTAIN OPERATOR LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN JAKOBOVITS (MANAGER)
(732) 779-1030
Entity
Organization
Contact information
Practice address
141 S MAIN ST, BOONSBORO, MD 21713-1203
(301) 432-5457
Mailing address
709 KERSEY RD, SILVER SPRING, MD 20902-3054
(410) 207-4099
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
—
—
Other
Enumeration date
09/11/2017
Last updated
09/11/2017
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