Provider Demographics
NPI:1740563931
Name:LORIEN LIFE CENTER - HOWARD II, INC.
Entity Type:Organization
Organization Name:LORIEN LIFE CENTER - HOWARD II, INC.
Other - Org Name:LORIEN NURSING & REHABILITATION CENTER - ELKRIDGE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-750-7500
Mailing Address - Street 1:3300 N RIDGE RD
Mailing Address - Street 2:SUITE 390
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3383
Mailing Address - Country:US
Mailing Address - Phone:410-750-7500
Mailing Address - Fax:
Practice Address - Street 1:7615 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:ELKRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21075-6443
Practice Address - Country:US
Practice Address - Phone:410-579-2626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-23
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTO BE APPLIED FOR313M00000X, 314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes313M00000XNursing & Custodial Care FacilitiesNursing Facility/Intermediate Care Facility
No314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility