Provider Demographics
NPI:1265631246
Name:RISING SUN FAMILY CARE CENTER, INC.
Entity Type:Organization
Organization Name:RISING SUN FAMILY CARE CENTER, INC.
Other - Org Name:NAZARENE ADULT DAY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:YOLANDA
Authorized Official - Last Name:NOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-658-6000
Mailing Address - Street 1:2626 TOME HWY
Mailing Address - Street 2:
Mailing Address - City:COLORA
Mailing Address - State:MD
Mailing Address - Zip Code:21917-1214
Mailing Address - Country:US
Mailing Address - Phone:410-658-6000
Mailing Address - Fax:410-658-0041
Practice Address - Street 1:2626 TOME HWY
Practice Address - Street 2:
Practice Address - City:COLORA
Practice Address - State:MD
Practice Address - Zip Code:21917-1214
Practice Address - Country:US
Practice Address - Phone:410-658-6000
Practice Address - Fax:410-658-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-11
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD12733261QA0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care