Healthcare Provider Details

I. General information

NPI: 1972428167
Provider Name (Legal Business Name): PRII SL CROFTON 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

1301 CLARITY DRIVE
CROFTON MD
21114
US

IV. Provider business mailing address

1301 CLARITY DRIVE
CROFTON MD
21114
US

V. Phone/Fax

Practice location:
  • Phone: 443-494-6901
  • Fax: 443-494-6597
Mailing address:
  • Phone: 443-494-6901
  • Fax: 443-494-6597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: BRIAN ENGLE
Title or Position: AUTHORIZED SIGNATORY
Credential:
Phone: 443-494-6901