Healthcare Provider Details

I. General information

NPI: 1912431412
Provider Name (Legal Business Name): NORTH PLACE OPERATING COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2017
Last Update Date: 04/12/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 NORTH PL
FREDERICK MD
21701-6200
US

IV. Provider business mailing address

5300 W SAM HOUSTON PKWY N SUITE 100
HOUSTON TX
77041-5161
US

V. Phone/Fax

Practice location:
  • Phone: 301-695-6618
  • Fax:
Mailing address:
  • Phone: 832-467-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateMD

VIII. Authorized Official

Name: KELLE C SANTORO
Title or Position: SR DIRECTOR AR
Credential:
Phone: 832-467-5728