Provider Demographics
NPI:1831190271
Name:LORIEN TANEYTOWN, INC
Entity type:Organization
Organization Name:LORIEN TANEYTOWN, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRIMMEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-750-7500
Mailing Address - Street 1:100 ANTRIM BLVD
Mailing Address - Street 2:
Mailing Address - City:TANEYTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21787-2277
Mailing Address - Country:US
Mailing Address - Phone:410-756-5884
Mailing Address - Fax:410-756-5894
Practice Address - Street 1:100 ANTRIM BLVD
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2277
Practice Address - Country:US
Practice Address - Phone:410-756-5884
Practice Address - Fax:410-756-5894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06022314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD215348Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER