Provider Demographics
NPI:1467749911
Name:THE RESIDENCE ON GREENBELT
Entity Type:Organization
Organization Name:THE RESIDENCE ON GREENBELT
Other - Org Name:REXFORD PLACE
Other - Org Type:Other Name
Authorized Official - Title/Position:AREA DIRECTOR SALES & MARKETING
Authorized Official - Prefix:MS
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:M
Authorized Official - Last Name:MALKO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:724-940-5544
Mailing Address - Street 1:9885 GREENBELT ROAD
Mailing Address - Street 2:
Mailing Address - City:LANHAM
Mailing Address - State:MD
Mailing Address - Zip Code:20706
Mailing Address - Country:US
Mailing Address - Phone:301-486-1590
Mailing Address - Fax:301-486-1591
Practice Address - Street 1:9885 GREENBELT ROAD
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706
Practice Address - Country:US
Practice Address - Phone:301-486-1590
Practice Address - Fax:301-486-1591
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTEGRACARE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-06
Last Update Date:2011-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16AL491310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility