205 Armstrong Avenue Operations LLC
Organization Active NPI Physical Therapist · Centreville, MD
NPI 1043664428 · NPPES record last updated Aug 31, 2017
Key facts
- NPI
- 1043664428
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 17001 (MD)
- Legal business name
- 205 ARMSTRONG AVENUE OPERATIONS LLC
- Practice address
- 205 Armstrong St
Centreville, MD 21617-2125 - Phone
- (410) 758-2323
- NPI assigned
- Apr 21, 2016
- Organization subpart
- No
Authorized official
- Name
- Michael T. Berg
- Title
- Assistant Secretary
- Phone
- (505) 468-4752
Corporate family (same tax ID) 1
National Provider Directory
- Tax ID family
- 205 Armstrong Avenue Operations LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 17001 | MD | Yes |
| Occupational Therapist |
225X00000X | 17001 | MD |
Addresses
Primary practice location
205 Armstrong St
Centreville, MD 21617-2125
Mailing address
205 Armstrong St
Centreville, MD 21617-2125
Phone (410) 758-2323
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 442803000 | Medicaid | MD |
Other names
- Corsica Hills Center
Other providers in Centreville, MD
- 205 Armstrong Avenue Operations LLC
- Absolute Health and Wellness
- Farooq Adetola
- Lisa Lister Adkins
- Advita Health LLC
All providers in Centreville, MD · Physical Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 31, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.