Provider Demographics
NPI:1578003273
Name:BRINTON WOODS OF BOONSBORO, LLC
Entity Type:Organization
Organization Name:BRINTON WOODS OF BOONSBORO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:CORTESE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-560-4925
Mailing Address - Street 1:9515 DEERECO RD
Mailing Address - Street 2:SUITE 407
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2116
Mailing Address - Country:US
Mailing Address - Phone:410-560-4925
Mailing Address - Fax:410-560-4927
Practice Address - Street 1:141 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BOONSBORO
Practice Address - State:MD
Practice Address - Zip Code:21713-1203
Practice Address - Country:US
Practice Address - Phone:301-432-5457
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility