Healthcare Provider Details

I. General information

NPI: 1588589766
Provider Name (Legal Business Name): PRII SL ANNAPOLIS OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1935 GENERALS HWY
ANNAPOLIST MD
21401
US

IV. Provider business mailing address

1935 GENERALS HWY
ANNAPOLIST MD
21401
US

V. Phone/Fax

Practice location:
  • Phone: 443-808-1232
  • Fax: 443-499-8270
Mailing address:
  • Phone: 443-808-1232
  • Fax: 443-499-8270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN ENGLE
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 410-962-0595