Provider Demographics
NPI:1245736008
Name:BIRCH MANOR HEALTHCARE CENTER, LLC
Entity Type:Organization
Organization Name:BIRCH MANOR HEALTHCARE CENTER, 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:
Authorized Official - Phone:410-729-8406
Mailing Address - Street 1:8227 CLOVERLEAF DR STE 309
Mailing Address - Street 2:
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-1536
Mailing Address - Country:US
Mailing Address - Phone:410-729-8406
Mailing Address - Fax:410-987-2430
Practice Address - Street 1:7309 2ND AVE
Practice Address - Street 2:
Practice Address - City:SYKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21784-7531
Practice Address - Country:US
Practice Address - Phone:844-334-3818
Practice Address - Fax:410-987-2430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility