2700 South Haven Road Opco LLC

Organization Active NPI Skilled Nursing Facility · Annapolis, MD

NPI 1134878283 · NPPES record last updated Mar 23, 2022

Key facts

NPI
1134878283
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
Legal business name
2700 SOUTH HAVEN ROAD OPCO LLC
Practice address
2700 Southaven Rd
Annapolis, MD 21401-7122
Phone
(410) 897-1300
NPI assigned
Mar 23, 2022
Organization subpart
No

Authorized official

Name
Sam Stern
Title
Cfo
Phone
(877) 567-0402

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X
Skilled Nursing Facility 314000000X Yes
Respite Care 385H00000X

Addresses

Primary practice location

2700 Southaven Rd
Annapolis, MD 21401-7122

Mailing address

14C 53Rd St
Brooklyn, NY 11232-2644
Phone (877) 567-0402

Other names

  • Autumn Lake Healthcare at South Haven Doing business as

Other providers in Annapolis, MD

All providers in Annapolis, MD · Skilled Nursing Facility in Maryland

Sources for this page

Verify at the official NPI Registry.