Provider Demographics
NPI:1760718951
Name:REFRESHING SPRINGS ASSISTED LIVING HOMES, INC
Entity Type:Organization
Organization Name:REFRESHING SPRINGS ASSISTED LIVING HOMES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ROBB
Authorized Official - Suffix:
Authorized Official - Credentials:RN, BSN
Authorized Official - Phone:240-486-9899
Mailing Address - Street 1:12301 KEMMERTON LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2722
Mailing Address - Country:US
Mailing Address - Phone:240-486-9899
Mailing Address - Fax:301-433-4932
Practice Address - Street 1:14519 TURNER WOOTTON PKWY
Practice Address - Street 2:
Practice Address - City:UPPER MARLBORO
Practice Address - State:MD
Practice Address - Zip Code:20774-8693
Practice Address - Country:US
Practice Address - Phone:240-353-1904
Practice Address - Fax:301-433-4932
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-23
Last Update Date:2009-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16AL0877310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility