Provider Demographics
NPI:1326005034
Name:NEXION HEALTH AT TERRELL MANOR, INC.
Entity Type:Organization
Organization Name:NEXION HEALTH AT TERRELL MANOR, INC.
Other - Org Name:TERRELL MANOR
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:P
Authorized Official - Last Name:KIRLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-552-4800
Mailing Address - Street 1:1430 PROGRESS WAY
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ELDERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21784-6429
Mailing Address - Country:US
Mailing Address - Phone:410-552-4800
Mailing Address - Fax:410-552-4837
Practice Address - Street 1:1800 N FRANCES ST
Practice Address - Street 2:
Practice Address - City:TERRELL
Practice Address - State:TX
Practice Address - Zip Code:75160-1217
Practice Address - Country:US
Practice Address - Phone:972-563-2652
Practice Address - Fax:972-563-0828
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX004528314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX45E713Medicare ID - Type UnspecifiedPROVIDER NUMBER
TX675955Medicare ID - Type UnspecifiedPROVIDER NUMBER