Provider Demographics
NPI:1740265438
Name:LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL
Entity type:Organization
Organization Name:LEVINDALE HEBREW GERIATRIC CENTER AND HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ATTENDING PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:BRAHIM
Authorized Official - Middle Name:
Authorized Official - Last Name:ELOUARDIGHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:202-602-2246
Mailing Address - Street 1:2434 W BELVEDERE AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21215-5202
Mailing Address - Country:US
Mailing Address - Phone:410-601-2246
Mailing Address - Fax:410-601-2924
Practice Address - Street 1:2434 W BELVEDERE AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21215-5202
Practice Address - Country:US
Practice Address - Phone:410-601-2246
Practice Address - Fax:410-601-2924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-14
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD63174314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI369993Medicare UPIN