Provider Demographics
NPI:1255574927
Name:DANNEWYL OF LAUREL, LLC
Entity type:Organization
Organization Name:DANNEWYL OF LAUREL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR/ASSISTED LIVING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:QUENTIS
Authorized Official - Middle Name:AMANDA
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-497-1852
Mailing Address - Street 1:11504 BASSWOOD CT
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20708-3172
Mailing Address - Country:US
Mailing Address - Phone:301-497-1852
Mailing Address - Fax:301-776-4082
Practice Address - Street 1:11504 BASSWOOD CT
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20708-3172
Practice Address - Country:US
Practice Address - Phone:301-497-1852
Practice Address - Fax:301-776-4082
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD16AL0941-A310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility