Provider Demographics
NPI:1376568261
Name:SPRINGVALE TERRACE INC.
Entity Type:Organization
Organization Name:SPRINGVALE TERRACE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MOTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-587-0190
Mailing Address - Street 1:8505 SPRINGVALE RD
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-4344
Mailing Address - Country:US
Mailing Address - Phone:301-587-0190
Mailing Address - Fax:301-588-1126
Practice Address - Street 1:8505 SPRINGVALE RD
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-4344
Practice Address - Country:US
Practice Address - Phone:301-587-0190
Practice Address - Fax:301-588-1126
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-13
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15AL0290310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD48702350600Medicaid