Provider Demographics
NPI:1871831222
Name:ASHBY PONDS, INC.
Entity Type:Organization
Organization Name:ASHBY PONDS, INC.
Other - Org Name:CONTINUING CARE AT ASHBY PONDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:WALTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-402-2315
Mailing Address - Street 1:21170 ASHBY PONDS BLVD
Mailing Address - Street 2:ATTN: EXECUTIVE DIRECTOR
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147-6128
Mailing Address - Country:US
Mailing Address - Phone:703-723-1999
Mailing Address - Fax:410-204-7237
Practice Address - Street 1:21160 MAPLE BRANCH TER
Practice Address - Street 2:ATTN: EXTENDED CARE ADMINISTRATOR
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-6160
Practice Address - Country:US
Practice Address - Phone:703-723-1999
Practice Address - Fax:410-204-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-18
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VANH2774314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA495416Medicare Oscar/Certification