Organization Active NPI

General German Aged Peoples Home of Baltimore

  • Skilled Nursing Facility
  • Towson, MD
National Provider Identifier
1205239688
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
GENERAL GERMAN AGED PEOPLES HOME OF BALTIMORE
Practice address
800 Southerly Rd
Towson, MD 21286-8403
Phone
(410) 339-6000
Fax
(410) 583-8786
NPI assigned
Sep 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Roland Devasher
Title
V.P. of Finance & Administration
Phone
(410) 339-6013

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X 03AL618-H MD
Skilled Nursing Facility 314000000X Primary

Addresses

Primary practice location

800 Southerly Rd
Towson, MD 21286-8403

Mailing address

800 Southerly Rd
Towson, MD 21286-8403
Phone (410) 339-6000

Other names 1

  • Edenwald Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201019003103 MD Part A Provider - Skilled Nursing Facility 3375963085 Practice locations: Towson, MD

Skilled nursing facility certification: CCN 215372

Legal name
GENERAL GERMAN AGED PEOPLES HOME OF BALTIMORE
Doing business as
EDENWALD
Certification status
Active
Provider type (POS)
Nursing home – SNF (Medicare) only
Participating since
Aug 5, 2022
Last certification
Jun 17, 2022
Beds
70
Ownership / control type
Corporation
Organization structure
CorporationNon-profit
Incorporated
Jun 8, 1881 in MD
Enrollment address
800 Southerly Road
Towson, MD 21286-8403
Nursing home name
EDENWALD

Care Compare: Nursing home

Medicare Care Compare
Listed as
EdenwaldCCN 215372
Overall star rating
5 of 5
Health inspections
5 of 5
Staffing
5 of 5
Quality measures
5 of 5
Type
Medicare
Ownership
For profit - Corporation
Certified
Aug 5, 2022
Medicare certification status
ActiveFrom the Provider of Services file
Certified beds
7033.7 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2201430Edenwald800 Southerly Road, Towson, MD 21286Certificate of waiverNov 19, 2026

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 29

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Frank Palumbo Individual Corporate OfficerTreasurer Jan 1, 2025
Aira Bautista-O'Donnell Individual Operational/Managerial Control Apr 5, 2024
Adp of the SNF Jul 17, 2025
Andri Purkanto Individual Corporate Officer Jan 1, 2025
Individual Adp of the SNF Apr 4, 2019
Lori Wolford Individual Operational/Managerial Control Apr 5, 2024
Candace Richardson Individual Corporate OfficerBoard Member Jan 1, 2025
Individual Adp of the SNF Mar 1, 2016
Individual Adp of the SNF Jan 2, 2023
Debra S Wertheimer Individual Corporate OfficerBoard Member Jan 1, 2025
Tim Wessel Individual Corporate OfficerBoard Member Jan 1, 2025
Individual Adp of the SNF May 2, 2005
Shanetrica Chester Individual Operational/Managerial Control Mar 31, 2025
Adp of the SNF Mar 31, 2025
Cory Silkman Individual Corporate OfficerBoard Member Jan 1, 2025
Astrid Wexler Individual Corporate OfficerBoard Member Jan 1, 2025
Remi Ackerman Individual Corporate OfficerVP of Finance and Administration Feb 28, 2025
Operational/Managerial Control Feb 28, 2025
Individual Adp of the SNF Aug 8, 2019
Individual Adp of the SNF Mar 31, 2005
Individual Adp of the SNF May 6, 2005
Individual Adp of the SNF May 7, 2005
Individual Adp of the SNF Jan 14, 2023
Individual Adp of the SNF Dec 14, 2021
Mark Beggs Individual Corporate OfficerCeo/President Dec 1, 2022
Individual Adp of the SNF Apr 14, 2005
Vince Nesline Individual Corporate OfficerChairman of the Board Dec 20, 2020
Larry Cook Individual Corporate OfficerBoard Member Jan 1, 2025
Scott Ensor Individual Corporate OfficerBoard Member - Secretary Jan 1, 2025
Individual Adp of the SNF Oct 24, 2021
Andrew Moore Individual Corporate OfficerBoard Member Jan 1, 2025
Individual Adp of the SNF Dec 4, 2023

Practitioners & affiliated clinicians

Affiliated clinicians 1

Clinicians who list this facility as an affiliation in Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1205239688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SOUTHERLY RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868403",
            "telephone_number": "410-339-6000",
            "fax_number": "410-583-8786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SOUTHERLY RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868403",
            "telephone_number": "410-339-6000",
            "fax_number": "410-583-8786"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENERAL GERMAN AGED PEOPLES HOME OF BALTIMORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "DEVASHER",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_title_or_position": "V.P. OF FINANCE & ADMINISTRATION",
        "authorized_official_telephone_number": "410-339-6013"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "03AL618-H",
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edenwald",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Edenwald",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

Verify at the official NPI Registry.