Provider Demographics
NPI:1114311313
Name:THE GABLES AT CAROLINE, LLC
Entity Type:Organization
Organization Name:THE GABLES AT CAROLINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:G
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:410-729-8406
Mailing Address - Street 1:701 S 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:MD
Mailing Address - Zip Code:21629-1364
Mailing Address - Country:US
Mailing Address - Phone:410-479-2371
Mailing Address - Fax:
Practice Address - Street 1:701 S 5TH AVE
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:MD
Practice Address - Zip Code:21629-1364
Practice Address - Country:US
Practice Address - Phone:410-479-2371
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-25
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility