Healthcare Provider Details
I. General information
NPI: 1437699337
Provider Name (Legal Business Name): BRINTON WOODS OF FROSTBURG, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2017
Last Update Date: 02/27/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1 KAYLOR CIR
FROSTBURG MD
21532-2009
US
IV. Provider business mailing address
9515 DEERECO RD SUITE 407
TIMONIUM MD
21093-2116
US
V. Phone/Fax
- Phone: 301-689-7480
- Fax:
- Phone: 410-560-4925
- Fax: 410-560-4927
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
DAREN
CORTESE
Title or Position: PRESIDENT
Credential:
Phone: 410-560-4925