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NPI Code Detail

MEDICARE: MILLENNIUM HEALTH AND REHABILITATION CENTER OF ELLICOTT CITY LLC

MEDICARE: MILLENNIUM HEALTH AND REHABILITATION CENTER OF ELLICOTT CITY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1314000000XSkilled Nursing Facility13-008MD

General Provider Information

NPI Number : 1689612384
Entity Type Code : Organization
Provider Name (Legal Business Name) : MILLENNIUM HEALTH AND REHABILITATION CENTER OF ELLICOTT CITY LLC
Provider Business Mailing Address
First Line : 930 RIDGEBROOK RD
Second Line :
City : SPARKS
State : MD
Zip : 21152-9390
Country : US
Telephone Number : 410-773-1000
Fax Number :
Provider Business Practice Location Address
First Line : 3000 N RIDGE RD
Second Line :
City : ELLICOTT CITY
State : MD
Zip : 21043-3311
Country : US
Telephone Number : 410-461-7577
Fax Number :
Authorized Official
Title or Position : EVP
Name : MATTHEW BOX
Credential :
Telephone Number : 410-773-1000
Provider Enumeration Date : 06/03/2006
Last Update Date : 09/21/2007

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Directions to “MILLENNIUM HEALTH AND REHABILITATION CENTER OF ELLICOTT CITY LLC ” Practice Location

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