Provider Demographics
NPI:1619272705
Name:LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL
Entity Type:Organization
Organization Name:LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL
Other - Org Name:LEVINDALE OUTPATIENT MENTAL HEALTH SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR, ADULT DAY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-601-2361
Mailing Address - Street 1:2434 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5267
Mailing Address - Country:US
Mailing Address - Phone:410-601-2318
Mailing Address - Fax:410-601-2982
Practice Address - Street 1:2434 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5267
Practice Address - Country:US
Practice Address - Phone:410-601-2318
Practice Address - Fax:410-601-2982
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-01-20
Last Update Date:2011-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty