Healthcare Provider Details

I. General information

NPI: 1417959719
Provider Name (Legal Business Name): CARRIAGE HILL - BETHESDA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5215 W CEDAR LN
BETHESDA MD
20814-1500
US

IV. Provider business mailing address

5215 W CEDAR LN
BETHESDA MD
20814-1500
US

V. Phone/Fax

Practice location:
  • Phone: 301-897-5500
  • Fax:
Mailing address:
  • Phone: 301-897-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number15-021
License Number StateMD

VIII. Authorized Official

Name: MR. JAMES JARBOE
Title or Position: ADMINISTRATOR
Credential: N.H.A.
Phone: 301-897-5500