Provider Demographics
NPI:1417171372
Name:KENT CO. MEDICAL ADULT DAY CARE
Entity Type:Organization
Organization Name:KENT CO. MEDICAL ADULT DAY CARE
Other - Org Name:KENT COUNTY HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:HEALTH OFFICER/DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HEROY
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-778-1350
Mailing Address - Street 1:125 S LYNCHBURG ST
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-1146
Mailing Address - Country:US
Mailing Address - Phone:410-778-1350
Mailing Address - Fax:410-775-6119
Practice Address - Street 1:125 S LYNCHBURG ST
Practice Address - Street 2:
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1146
Practice Address - Country:US
Practice Address - Phone:410-778-1350
Practice Address - Fax:410-775-6119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD273473700Medicaid