Provider Demographics
NPI:1306222963
Name:2015 EAST WEST HIGHWAY OPERATIONS LLC
Entity Type:Organization
Organization Name:2015 EAST WEST HIGHWAY OPERATIONS LLC
Other - Org Name:FOX CHASE REHABILITATION AND NURSING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:505-468-4742
Mailing Address - Street 1:2015 E WEST HWY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2602
Mailing Address - Country:US
Mailing Address - Phone:301-587-2400
Mailing Address - Fax:301-587-2401
Practice Address - Street 1:2015 E WEST HWY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2602
Practice Address - Country:US
Practice Address - Phone:301-587-2400
Practice Address - Fax:301-587-2401
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SUMMIT CARE LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-08-06
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD00000314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility