700 Toll House Avenue Operations LLC

Organization Active NPI Skilled Nursing Facility · Frederick, MD

NPI 1427355353 · NPPES record last updated Mar 7, 2018

Key facts

NPI
1427355353
Entity type
Organization (NPI type 2)
Primary specialty
Skilled Nursing Facility 314000000X
License
10002 (MD)
Legal business name
700 TOLL HOUSE AVENUE OPERATIONS LLC
Practice address
347 Ballenger Ctr Dr
Frederick, MD 21703-7095
Phone
(301) 663-5181
Fax
(301) 663-3950
NPI assigned
Feb 11, 2011
Organization subpart
No

Authorized official

Name
Michael T. Berg
Title
Assistant Secretary
Phone
(505) 468-4752

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP
235Z00000X 10002 MD
Skilled Nursing Facility 314000000X 10002 MD Yes

Addresses

Primary practice location

347 Ballenger Ctr Dr
Frederick, MD 21703-7095

Mailing address

101 E State St
Kennett Square, PA 19348-3109
Phone (610) 925-4436

Other identifiers

IdentifierTypeStateIssuer
420462000MedicaidMD

Other providers in Frederick, MD

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

Sources for this page

Verify at the official NPI Registry.