Provider Demographics
NPI:1336412386
Name:HARMONY HALL ASSISTED LIVING
Entity Type:Organization
Organization Name:HARMONY HALL ASSISTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:NHA
Authorized Official - Phone:410-531-5300
Mailing Address - Street 1:6336 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3897
Mailing Address - Country:US
Mailing Address - Phone:410-531-6000
Mailing Address - Fax:410-531-0291
Practice Address - Street 1:6336 CEDAR LN
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3897
Practice Address - Country:US
Practice Address - Phone:410-531-6000
Practice Address - Fax:410-531-0291
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-21
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13AL054-H310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD5720005600Medicaid