Provider Demographics
NPI:1780399667
Name:COMPLETE CARE AT ANNAPOLIS LLC
Entity type:Organization
Organization Name:COMPLETE CARE AT ANNAPOLIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED SIGNER
Authorized Official - Prefix:
Authorized Official - First Name:SHALOM
Authorized Official - Middle Name:
Authorized Official - Last Name:STEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-267-8653
Mailing Address - Street 1:900 VAN BUREN ST
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21403-2124
Mailing Address - Country:US
Mailing Address - Phone:410-267-8653
Mailing Address - Fax:410-295-1228
Practice Address - Street 1:900 VAN BUREN ST
Practice Address - Street 2:
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21403-2124
Practice Address - Country:US
Practice Address - Phone:410-267-8653
Practice Address - Fax:410-295-1228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-16
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility