Healthcare Provider Details

I. General information

NPI: 1336297431
Provider Name (Legal Business Name): LEVINDALE HEBREW GERIATRIC CENTER & HOSPITAL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2434 W BELVEDERE AVE
BALTIMORE MD
21215-5202
US

IV. Provider business mailing address

2434 W BELVEDERE AVE
BALTIMORE MD
21215-5202
US

V. Phone/Fax

Practice location:
  • Phone: 410-547-8500
  • Fax:
Mailing address:
  • Phone: 410-547-8500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code281P00000X
TaxonomyChronic Disease Hospital
License Number30088
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number8204
License Number StateMD

VIII. Authorized Official

Name: DR. SUSAN LEVY
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 410-601-2246