899 Cecil Avenue Operations LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

02-010 Issued in MD

Legal business name

899 CECIL AVENUE OPERATIONS LLC

Doing business as

Waugh Chapel Center

Practice address

1221 Waugh Chapel Rd
Gambrills, MD 21054-1608

Phone

(410) 923-2020

Fax

(410) 987-1600

NPI assigned

Nov 27, 2007

Last updated

Jan 15, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michael T. Berg

Title

Assistant Secretary

Phone

(505) 468-4752

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Waugh Chapel Center Doing business as

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452816000000",
    "number": "1770765240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4436",
            "fax_number": "610-925-4351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 WAUGH CHAPEL RD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541608",
            "telephone_number": "410-923-2020",
            "fax_number": "410-987-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "899 CECIL AVENUE OPERATIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-27",
        "last_updated": "2016-01-15",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "505-468-4752"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "02-010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "413989500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Waugh Chapel Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• 1221 Waugh Chapel Opco LLC (Autumn Lake Healthcare at Waugh Chapel)
• 899 Cecil Avenue Operations LLC (Waugh Chapel Center)
• Above (B2) (Righttime Medical Care - Gambrills)
• Luz Abrera-Crum, D.D.S.
• Amitice Abtahi
• Ac Medical LLC

• Skilled Nursing Facility in Gambrills, MD
• Providers in Gambrills, 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 Jan 15, 2016; 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.