Holbrock Estates at 3021 Garrison Boulevard LLC

Primary specialty

Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X

Legal business name

HOLBROCK ESTATES AT 3021 GARRISON BOULEVARD LLC

Practice address

3021 Garrison Blvd
Baltimore, MD 21216-2070

Phone

(443) 708-5056

NPI assigned

Mar 26, 2022

Organization subpart

No

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

Authorized official

Name

Vernon Holmes Jr.

Title

Ceo

Phone

(667) 400-0602

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1648252800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729468800000",
    "number": "1710637335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 S CONKLING ST STE 1",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242460",
            "telephone_number": "443-539-8508",
            "fax_number": "443-539-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3021 GARRISON BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212162070",
            "telephone_number": "443-708-5056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLBROCK ESTATES AT 3021 GARRISON BOULEVARD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-26",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "VERNON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "667-400-0602",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Assisted Living Facility (Mental Illness) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Assisted Living Facility (Mental Illness) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; 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.