Liberty Rd Randallstown MD Opco LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

LIBERTY RD RANDALLSTOWN MD OPCO LLC

Doing business as

Patapsco Health and Rehabilitation

Practice address

9109 Liberty Rd
Randallstown, MD 21133-3521

Phone

(410) 655-7373

NPI assigned

Dec 11, 2019

Organization subpart

No

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

Authorized official

Name

Sam Stern

Title

Cfo

Phone

(877) 567-0402

Specialties & licenses 3

Addresses

Other names 1

• Patapsco Health and Rehabilitation Doing business as

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591228800000",
    "number": "1427696376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 SYLVAN AVE STE 240",
            "city": "ENGLEWOOD CLIFFS",
            "state": "NJ",
            "postal_code": "076322700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9109 LIBERTY RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211333521",
            "telephone_number": "410-655-7373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY RD RANDALLSTOWN MD OPCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-11",
        "last_updated": "2020-06-04",
        "certification_date": "2020-06-04",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "877-567-0402"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Patapsco Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Patapsco Health and Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Skilled Nursing Facility in Randallstown, MD
• Providers in Randallstown, MD by specialty
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; 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.