Healthcare Provider Details

I. General information

NPI: 1982690558
Provider Name (Legal Business Name): MARIA HEALTH CARE CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6401 N CHARLES ST
BALTIMORE MD
21212-1016
US

IV. Provider business mailing address

6401 N CHARLES ST
BALTIMORE MD
21212-1016
US

V. Phone/Fax

Practice location:
  • Phone: 410-377-7774
  • Fax: 410-377-6042
Mailing address:
  • Phone: 410-377-7774
  • Fax: 410-377-6042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number03-069
License Number StateMD

VIII. Authorized Official

Name: GRACE SCIAMANNA
Title or Position: ADMINISTRATOR
Credential: NHA
Phone: 410-377-7774