Provider Demographics
NPI:1205052909
Name:GEORGES CREEK ADULT CARE CENTER
Entity type:Organization
Organization Name:GEORGES CREEK ADULT CARE CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROGRAM DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:LSWA
Authorized Official - Phone:301-463-4085
Mailing Address - Street 1:19 FREDERICK ST
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2309
Mailing Address - Country:US
Mailing Address - Phone:301-777-5970
Mailing Address - Fax:301-722-0937
Practice Address - Street 1:7 HANEKAMP STREET
Practice Address - Street 2:2ND FLOOR
Practice Address - City:LONACONING
Practice Address - State:MD
Practice Address - Zip Code:21539
Practice Address - Country:US
Practice Address - Phone:301-463-4085
Practice Address - Fax:301-463-4076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD15900314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility