Provider Demographics
NPI:1629586136
Name:WESTFIELD ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:WESTFIELD ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:L
Authorized Official - Last Name:SALTER
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:443-708-0108
Mailing Address - Street 1:2822 LOUISE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21214-1237
Mailing Address - Country:US
Mailing Address - Phone:443-708-0108
Mailing Address - Fax:
Practice Address - Street 1:2822 LOUISE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21214-1237
Practice Address - Country:US
Practice Address - Phone:443-708-0108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30AL3577-A310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility