NPIMap

Organization Active NPI

Denton Operator, LLC

Doing business as Autumn Lake Healthcare at Denton

  • Skilled Nursing Facility
  • Denton, MD
National Provider Identifier
1649762337
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
DENTON OPERATOR, LLC
Doing business as
Autumn Lake Healthcare at Denton
Practice address
420 Colonial Dr
Denton, MD 21629-3055
Phone
(410) 479-4400
NPI assigned
May 30, 2018
Last updated
May 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Authorized official

Name
Sam Stern
Title
Cfo
Phone
(718) 567-0400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X MD Primary
Respite Care 385H00000X MD

Addresses

Primary practice location

420 Colonial Dr
Denton, MD 21629-3055

Mailing address

14C 53Rd St
Brooklyn, NY 11232-2644

Other names 1

  • Autumn Lake Healthcare at Denton Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1527638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1649762337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14C 53RD ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112322644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 COLONIAL DR",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216293055",
            "telephone_number": "410-479-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENTON OPERATOR, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-30",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "718-567-0400"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": null,
            "primary": true
        },
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Healthcare at Denton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2018; 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.