Provider Demographics
NPI:1407847247
Name:ANNAPOLIS LIFE CARE, INC.
Entity Type:Organization
Organization Name:ANNAPOLIS LIFE CARE, INC.
Other - Org Name:GINGER COVE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-266-7300
Mailing Address - Street 1:4000 RIVER CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401-7721
Mailing Address - Country:US
Mailing Address - Phone:410-266-7300
Mailing Address - Fax:410-266-6144
Practice Address - Street 1:4000 RIVER CRESCENT DR
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7721
Practice Address - Country:US
Practice Address - Phone:410-266-7300
Practice Address - Fax:410-266-6144
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD02-001314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD215174Medicare ID - Type Unspecified