Provider Demographics
NPI:1972869410
Name:FREDERICK OPERATING, LLC
Entity Type:Organization
Organization Name:FREDERICK OPERATING, LLC
Other - Org Name:TRANQUILLITY AT FREDERICKTOWNE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT AND SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:GERARD
Authorized Official - Middle Name:W
Authorized Official - Last Name:FARRELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:610-565-7821
Mailing Address - Street 1:2 WEST BALTIMORE AVENUE, SUITE 350
Mailing Address - Street 2:C/O CAPITAL HEALTH GROUP, LLC
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-3924
Mailing Address - Country:US
Mailing Address - Phone:610-565-7821
Mailing Address - Fax:610-565-6198
Practice Address - Street 1:6441 JEFFERSON PIKE
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-7039
Practice Address - Country:US
Practice Address - Phone:301-668-6030
Practice Address - Fax:301-668-6034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility