Organization
CLOSUP I, INC.
Active
Other names
Edenton Retirement Community
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RAEANN E. BUTLER (ADMINISTRATOR)
(301) 694-3100
Entity
Organization
Contact information
Practice address
5800 GENESIS LN, FREDERICK, MD 21703-5116
(301) 694-3100
(301) 694-0745
Mailing address
5800 GENESIS LN, FREDERICK, MD 21703-5116
(301) 694-3100
(301) 694-0745
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
10AL011
MD
310400000X
Assisted Living Facility
10AL021
MD
Other
Enumeration date
11/16/2005
Last updated
08/22/2020
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