Provider Demographics
NPI: | 1477701795 |
---|---|
Name: | ARDEN COURTS OF TOWSON MD LLC |
Entity Type: | Organization |
Organization Name: | ARDEN COURTS OF TOWSON MD LLC |
Other - Org Name: | ARDEN COURTS OF TOWSON |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | VICE PRESIDENT-REIMBURSEMENT |
Authorized Official - Prefix: | MR |
Authorized Official - First Name: | BARRY |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | LAZARUS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 419-252-5541 |
Mailing Address - Street 1: | 333 N SUMMIT ST |
Mailing Address - Street 2: | ATTN BARRY A LAZARUS |
Mailing Address - City: | TOLEDO |
Mailing Address - State: | OH |
Mailing Address - Zip Code: | 43604-1531 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 419-252-5541 |
Mailing Address - Fax: | 419-254-5494 |
Practice Address - Street 1: | 509 E JOPPA RD |
Practice Address - Street 2: | |
Practice Address - City: | TOWSON |
Practice Address - State: | MD |
Practice Address - Zip Code: | 21286-5404 |
Practice Address - Country: | US |
Practice Address - Phone: | 410-847-9400 |
Practice Address - Fax: | 410-821-0600 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2008-08-28 |
Last Update Date: | 2008-08-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 310400000X | Nursing & Custodial Care Facilities | Assisted Living Facility |