Provider Demographics
NPI:1518412675
Name:WHITE PLAINS HEALTH CARE LLC
Entity Type:Organization
Organization Name:WHITE PLAINS HEALTH CARE LLC
Other - Org Name:RESTORE HEALTH REHABILITATION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LUDLOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-448-2000
Mailing Address - Street 1:4615 EINSTEIN PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:MD
Mailing Address - Zip Code:20695-4119
Mailing Address - Country:US
Mailing Address - Phone:240-448-2000
Mailing Address - Fax:301-638-0564
Practice Address - Street 1:4615 EINSTEIN PL
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:MD
Practice Address - Zip Code:20695-4119
Practice Address - Country:US
Practice Address - Phone:240-448-2000
Practice Address - Fax:301-638-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD424421400Medicaid
MD424421400Medicaid