Provider Demographics
NPI:1306843578
Name:ADVENTIST SENIOR LIVING SERVICES
Entity Type:Organization
Organization Name:ADVENTIST SENIOR LIVING SERVICES
Other - Org Name:ADVENTIST HEALTHCARE- ASLS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, CENTRAL BUSINESS OFFICE
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:A
Authorized Official - Last Name:MARIZAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-315-3272
Mailing Address - Street 1:1801 RESEARCH BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-3152
Mailing Address - Country:US
Mailing Address - Phone:301-315-3450
Mailing Address - Fax:301-315-3359
Practice Address - Street 1:1801 RESEARCH BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-3152
Practice Address - Country:US
Practice Address - Phone:301-315-3450
Practice Address - Fax:301-315-3359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-07-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD0379270001Medicare NSC