Provider Demographics
NPI:1811155369
Name:CHARLES COUNTY NURSING AND REHAB CTR
Entity type:Organization
Organization Name:CHARLES COUNTY NURSING AND REHAB CTR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MORRIS
Authorized Official - Last Name:HOLMAN
Authorized Official - Suffix:JR
Authorized Official - Credentials:CPA
Authorized Official - Phone:301-934-1900
Mailing Address - Street 1:10200 LAPIATA RD
Mailing Address - Street 2:
Mailing Address - City:LAPIATA
Mailing Address - State:MD
Mailing Address - Zip Code:20646-3245
Mailing Address - Country:US
Mailing Address - Phone:301-934-1900
Mailing Address - Fax:301-934-8706
Practice Address - Street 1:10200 LAPIATA RD
Practice Address - Street 2:
Practice Address - City:LAPIATA
Practice Address - State:MD
Practice Address - Zip Code:20646-3245
Practice Address - Country:US
Practice Address - Phone:301-934-1900
Practice Address - Fax:301-934-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care