Provider Demographics
NPI:1326312133
Name:MORNINGSIDE HOUSE OF FRIENDSHIP
Entity Type:Organization
Organization Name:MORNINGSIDE HOUSE OF FRIENDSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:703-669-1804
Mailing Address - Street 1:7548 OLD TELEGRAPH RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:MD
Mailing Address - Zip Code:21076-1566
Mailing Address - Country:US
Mailing Address - Phone:410-863-0830
Mailing Address - Fax:410-863-0230
Practice Address - Street 1:7548 OLD TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MD
Practice Address - Zip Code:21076-1566
Practice Address - Country:US
Practice Address - Phone:410-863-0830
Practice Address - Fax:410-863-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-27
Last Update Date:2012-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02AL160-G310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility