Joint Retirement Convent Inc

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

03-070 Issued in MD

Legal business name

JOINT RETIREMENT CONVENT INC

Practice address

6806 Bellona Avenue
Baltimore, MD 21212-1299

Phone

(410) 377-2450

Fax

(410) 377-2501

NPI assigned

Dec 28, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Carol A Zaicko

Title

Administrator

Phone

(410) 377-2450

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• THE VILLA Doing business as

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

{
    "created_epoch": "1135728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286755200000",
    "number": "1528045986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 BELLONA AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121299",
            "telephone_number": "410-377-2450",
            "fax_number": "410-377-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6806 BELLONA AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212121299",
            "telephone_number": "410-377-2450",
            "fax_number": "410-377-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOINT RETIREMENT CONVENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-28",
        "last_updated": "2010-10-11",
        "status": "A",
        "authorized_official_last_name": "ZAICKO",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-377-2450",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "MD",
            "license": "03-070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510090900",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "981503100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE VILLA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Nursing Facility/Intermediate Care Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2010; 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.