Provider Demographics
NPI:1417959719
Name:CARRIAGE HILL - BETHESDA, INC.
Entity Type:Organization
Organization Name:CARRIAGE HILL - BETHESDA, INC.
Other - Org Name:CARRIAGE HILL - BETHESDA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:JARBOE
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:301-897-5500
Mailing Address - Street 1:5215 W CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1500
Mailing Address - Country:US
Mailing Address - Phone:301-897-5500
Mailing Address - Fax:
Practice Address - Street 1:5215 W CEDAR LN
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-1500
Practice Address - Country:US
Practice Address - Phone:301-897-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-06-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15-021314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD15-021OtherMARYLAND LICENSE
MD15-021OtherMARYLAND LICENSE