Holbrock Estates at 1638 Ruxton Avenue LLC

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

Legal business name

HOLBROCK ESTATES AT 1638 RUXTON AVENUE LLC

Practice address

1638 Ruxton Ave
Baltimore, MD 21216-3715

Phone

(443) 539-8508

Fax

(443) 539-8508

NPI assigned

Oct 21, 2024

Organization subpart

No

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

Authorized official

Name

Vernon Holmes

Title

Ceo

Phone

(667) 400-0602

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1729468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1225859499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S CONKLING ST STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242460",
            "telephone_number": "443-539-8508",
            "fax_number": "443-539-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 RUXTON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212163715",
            "telephone_number": "443-539-8508",
            "fax_number": "443-539-8508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROCK ESTATES AT 1638 RUXTON AVENUE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "667-400-0602"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.