Active NPI
Lorien Life Center Harford II, Inc.
- Nursing Facility/Intermediate Care Facility
- Havre de Grace, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nursing Facility/Intermediate Care Facility
- Legal business name
- LORIEN LIFE CENTER HARFORD II, INC.
- Practice address
- 1501 Blenheim Farm Lane
Havre de Grace, MD 21078 - Phone
- (410) 750-7500
- NPI assigned
- Dec 26, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Louis G. Grimmel Sr.
- Title
- Vice President
- Phone
- (410) 750-7500
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nursing Facility/Intermediate Care Facility | 313M00000X | Primary | ||
| Skilled Nursing Facility | 314000000X |
Addresses
Primary practice location
1501 Blenheim Farm Lane
Havre de Grace, MD 21078
Mailing address
1501 Blenheim Farm Lane
Havre de Grace, MD 21078
Other names 1
- Lorien Bulle Rock
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130404000077 | MD | Part A Provider - Skilled Nursing Facility | 0244475796 | Practice locations: Havre de Grace, MD |
Skilled nursing facility certification: CCN 215359
- Legal name
- LORIEN LIFE CENTER HARFORD II INC
- Doing business as
- LORIEN BULLE ROCK
- Certification status
- Active
- Provider type (POS)
- Nursing home – SNF/NF dual certification
- Participating since
- Jun 5, 2013
- Last certification
- Jun 28, 2022
- Beds
- 78
- Ownership / control type
- Corporation
- Multi-facility organization
- Lorien Health Services
- Organization structure
- Corporation
- Enrollment address
- 1501 Blenhiem Farm LN
Havre de Grace, MD 21078-2047 - Nursing home name
- LORIEN BULLE ROCK
- Affiliated entity
- LORIEN HEALTH SERVICES
Care Compare: Nursing home
Medicare Care Compare- Listed as
- Lorien Bulle Rock
- Overall star rating
- Health inspections
- Staffing
- Quality measures
- Type
- Medicare and Medicaid
- Ownership
- For profit - Corporation
- Certified
- Jun 5, 2013
- Medicare certification status
- Active
- Certified beds
- 78
- Chain
- Lorien Health Services
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2056878 | Lorien Life Center Harford II, Inc | Certificate of waiver | Apr 3, 2027 |
National Provider Directory
National Provider DirectoryOwnership & related parties
All disclosed owners & managing parties 12
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Nicholas Mangione | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Joanne Mangione | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Elissa Heck | W-2 Managing Employee | Apr 27, 2018 | |
| Peter Mangione | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Frances O'Keefe | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Louis Mangione | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Corporate Officer | Dec 17, 1998 | ||
| Samuel Mangione | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Michele M Collison | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| John Mangione | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Corporate Officer | Nov 28, 2012 | ||
| Louis Grimmel | Corporate Officer | Dec 27, 1998 | |
| Rosemary Juras | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | |
| Corporate Officer | Jan 1, 2003 | ||
| Linda Licata | 5% Or Greater Direct Ownership Interest | Dec 17, 1998 | 10% |
| Corporate Officer | Dec 17, 1998 |
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Internal Medicine Physician
- Linthicum Heights, MD
- NPI 1548286289
Affiliated clinicians 1
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Internal Medicine Physician
- Linthicum Heights, MD
- NPI 1548286289
Nursing home
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1356480000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1356480000000",
"number": "1376889121",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 BLENHEIM FARM LANE",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "21078"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 BLENHEIM FARM LANE",
"city": "HAVRE DE GRACE",
"state": "MD",
"postal_code": "21078",
"telephone_number": "410-750-7500"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LORIEN LIFE CENTER HARFORD II, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2012-12-26",
"last_updated": "2012-12-26",
"status": "A",
"authorized_official_last_name": "GRIMMEL",
"authorized_official_first_name": "LOUIS",
"authorized_official_middle_name": "G.",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "410-750-7500",
"authorized_official_name_prefix": "Mr.",
"authorized_official_name_suffix": "Sr."
},
"taxonomies": [
{
"code": "313M00000X",
"taxonomy_group": "",
"desc": "Nursing Facility/Intermediate Care Facility",
"state": null,
"license": null,
"primary": true
},
{
"code": "314000000X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Lorien Bulle Rock",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Havre de Grace, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.